| NPI | 1376110858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ROLLER Associate Director/Enrollment 770-312-5226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2022-08-16 |