| NPI | 1174533921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY CARROLL Office Manager 678-556-9460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 038817) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 038817) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2011-07-26 |