| NPI | 1639450877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY NGUYEN Chief Operations Officer 706-507-9209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 58922) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 58922) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2023-10-19 |