| NPI | 1912196775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI L MCCLESKEY Office Manager 770-979-2062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: GA 36567) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 36567) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 36567) | |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2012-05-18 |