RUSSELL PRENTICE PUCKETT

MARIETTA, GA
NPI1225723505
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2023-04-11
Last Update Date2023-04-11
Business Address
RUSSELL PRENTICE PUCKETT MD
677 CHURCH ST NE
MARIETTA, GA 30060-1101
Phone number: 770-793-5000
Mailing Address
RUSSELL PRENTICE PUCKETT MD
1422 N ENOTA AVE NW
GAINESVILLE, GA 30501-2271
Phone number: 770-778-8124