| NPI | 1609637099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM LARSEN Director Of Credentialing 770-874-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208M00000X Hospitalist | |
| 363L00000X Nurse Practitioner | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-01-22 |