PHOENIX MEDICAL OFFICE AT COLLEGE PARK,LLC

COLLEGE PARK, GA
NPI1396033064
Entity TypeOrganization
Authorized ContactKELVIN MAURICE HAMNER
Owner/Md
678-788-8950
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: GA  39813)
Enumeration Date2011-07-15
Last Update Date2012-12-11
Business Address
PHOENIX MEDICAL OFFICE AT COLLEGE PARK,LLC
1631 PHOENIX BLVD STE 4
COLLEGE PARK, GA 30349-5545
Phone number: 678-788-8950
Mailing Address
PHOENIX MEDICAL OFFICE AT COLLEGE PARK,LLC
1631 PHOENIX BLVD STE 4
COLLEGE PARK, GA 30349-5545
Phone number: 678-788-8950