| NPI | 1508121625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSIAH HAWKINS Practice Administrator 678-926-8599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2012-07-05 |