| NPI | 1407877764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUATOYA R TYSON Clinical Office Coordinator 404-607-1002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2011-12-13 |