| NPI | 1760813034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD EARL PENNINGTON Physician/Manager 678-954-8538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: GA 015299) |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2013-12-11 |