# ILYA WOLFSON M.D., INC

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

## Provider details

- **NPI number:** 1275761025
- **Authorized official:** ILYA WOLFSON M.D. (OWNER)
- **Authorized official phone:** (770) 591-4777

## Contact information

- **Practice address:** 3380 TRICKUM RD BLDG 1000-102, WOODSTOCK, GA 30188-3690
- **Practice address phone:** (770) 591-4777
- **Practice address fax:** (770) 406-2340
- **Mailing address:** 3380 TRICKUM RD BLDG 1000-102, WOODSTOCK, GA 30188-3690
- **Mailing address phone:** (770) 591-4777
- **Mailing address fax:** (770) 406-2340

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 051860 | GA | Yes |

## Other

- **Enumeration date:** 06/30/2009
- **Last updated:** 01/23/2025