| NPI | 1245255215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA S BOWEN Billing Specialist 706-745-2229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 051204) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 051204) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-08-22 |