NPI | 1386670404 |
---|---|
Doing Business As | ADVANCED GASTROENTEROLOGY GROUP |
Entity Type | Organization |
Authorized Contact | SHARON E JACKSON Office Manager 770-509-0089 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: GA 030681) |
Enumeration Date | 2006-06-23 |
Last Update Date | 2008-04-30 |