| NPI | 1790733244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEIRRA WALKER Credentialing Specialist 706-494-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| 208M00000X Hospitalist | |
| 207R00000X Internal Medicine | |
| 207X00000X Orthopaedic Surgery | |
| 103T00000X Psychologist | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-10-26 |