| NPI | 1649223173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELBY DODD LOGGINS Practice Administrator 770-532-6341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-08-22 |