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Organization
GA WOUND CARE MEDICAL GROUP
Active
Organization
GA WOUND CARE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OWEN BERNARDO ELLINGTON MD (PRESIDENT)
(713) 304-4227
Entity
Organization
Contact information
Practice address
2045 PEACHTREE RD NE STE 410, ATLANTA, GA 30309-1408
(323) 480-4075
Mailing address
5901 W CENTURY BLVD STE 750, LOS ANGELES, CA 90045-5443
(323) 480-4075
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
10/27/2022
Last updated
10/27/2022
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