| |
4550 Cobb Parkway Nw Suite 201 Acworth GA 30101 | |
(770) 974-4655 | |
(770) 974-7534 |
Full Name | |
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Speciality | Family Medicine |
Location | 4550 Cobb Parkway Nw, Acworth, Georgia |
Authorized Official Name and Position | Nicole Ashe (EXECUTIVE DIRECTOR OF FINANCE) |
Authorized Official Contact | 7707925261 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4550 Cobb Parkway Nw Suite 201 Acworth GA 30101 Ph: (770) 974-4655 | 4550 Cobb Parkway Nw Suite 201 Acworth GA 30101 Ph: (770) 974-4655 |
NPI Number | 1821352964 |
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Provider Enumeration Date | 07/03/2012 |
Last Update Date | 07/03/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821352964 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Georgia) | Primary |
207R00000X | Internal Medicine | (Georgia) | Secondary |
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