Physcians Immediate Med Of Canton, Pc

NPI 1013053115 - Clinic/Center - 261QU0200X

NPI Details
NPI 1013053115
Enumeration Date 01/29/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name CHARLES R CHARLES
Position OWNER
Phone (770) 720-7000
Fax (770) 720-7055
Practice Location
720 TRANSIT AVE STE 101
CANTON GA, 30114-2571, US
Phone (770) 720-7000
Fax (770) 720-7055
Business Location
720 TRANSIT AVE STE 101
CANTON GA, 30114-2571, US
Phone (770) 720-7000
Fax (770) 720-7055
Toxanomy
Taxonomy Code 261QU0200X
License State Georgia
License Number 035839
Remove 1013053115 NPI Number
 

According to our database, Physcians Immediate Med Of Canton, Pc NPI is 1013053115, taxonomy code is 261QU0200X and license number is 035839, license state is located at Georgia. Physcians Immediate Med Of Canton, Pc physically located at 720 Transit Ave Ste 101, Canton GA, 30114-2571. NPI Number 1033115704 has the healthcare provider type.

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1013053115 NPI number is provided on an as is basis without warranty of any kind. 1013053115 is maintained by the National Plan & Provider Enumeration System. The contents of Physcians Immediate Med Of Canton, Pc are for informational purposes only.