| NPI | 1275809295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD M BRYANT C.E.O. 770-981-6940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: GA POD000493) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: GA POD000493) |
| 305R00000X Preferred Provider Organization (Licence: GA POD000493) | |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2012-03-23 |