| NPI | 1780154914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY ALLEN Billing Manager 770-532-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2018-11-30 |