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1366456964
GREGORY TODD FOUNTAIN
LAWRENCEVILLE, GA
NPI
1366456964
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207V00000X Obstetrics & Gynecology
(Licence: GA 034593)
Enumeration Date
2006-07-28
Last Update Date
2022-08-17
Business Address
GREGORY TODD FOUNTAIN MD
766 WALTHER RD SUITE 100
LAWRENCEVILLE, GA 30046-8764
Phone number: 678-985-8001
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Mailing Address
GREGORY TODD FOUNTAIN MD
766 WALTHER ROAD SUITE 100
LAWRENCEVILLE, GA 30046
Phone number: 678-985-8001
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