| NPI | 1467825281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DEWAYNE COLQUITT Owner 404-735-0208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2015-11-12 |