| NPI | 1194515106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM LARSEN VP, Credentialing 770-874-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-12 |