| NPI | 1407947625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWEN JOHNSON Practice Administrator 706-323-5552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2024-12-10 |