# HOME PHYSICIAN CARE OF NORTHWEST GEORGIA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235545617
- **Authorized official:** DR. TOMMY DALTON BLEDSOE JR. MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (678) 986-6144

## Contact information

- **Practice address:** 1825 MCENTIRE CIR, CHATSWORTH, GA 30705-5945
- **Practice address phone:** (678) 986-6144
- **Mailing address:** 1825 MCENTIRE CIR, CHATSWORTH, GA 30705-5945
- **Mailing address phone:** (678) 986-6144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 364SA2200X | Adult Health Clinical Nurse Specialist | — | NULL | Yes |
| 364SA2200X | Adult Health Clinical Nurse Specialist | — | — | Yes |

## Other

- **Enumeration date:** 07/07/2014
- **Last updated:** 07/07/2014