# ROSWELL MEDICAL GROUP, LLC

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

## Provider details

- **NPI number:** 1275903296
- **Authorized official:** ALEXANDER K GEBHARDT DC (OWNER)
- **Authorized official phone:** (678) 878-3551

## Contact information

- **Practice address:** 11040 CRABAPPLE RD, ROSWELL, GA 30075-2457
- **Practice address phone:** (678) 878-3551
- **Practice address fax:** (678) 878-3552
- **Mailing address:** 11040 CRABAPPLE RD, ROSWELL, GA 30075-2457
- **Mailing address phone:** (678) 878-3551
- **Mailing address fax:** (678) 878-3552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | CHIR007542 | GA | — |
| 208D00000X | General Practice Physician | 20987 | GA | Yes |
| 208D00000X | General Practice Physician | 26935 | GA | — |

## Other

- **Enumeration date:** 10/02/2015
- **Last updated:** 04/03/2017