| NPI | 1669599866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY P WIGGINS Owner Physician 404-699-1339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 045137) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 044618) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |