| NPI | 1962964833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BAKER CEO 706-494-3290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207QS0010X Family Medicine, Sports Medicine | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 231H00000X Audiologist | |
| 363A00000X Physician Assistant | |
| 363AS0400X Physician Assistant, Surgical | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-08-29 |