# WATERFORD MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1366712846
- **Authorized official:** DR. JOHN SALINAS (MEDICAL DIRECTOR)
- **Authorized official phone:** (404) 992-9130

## Contact information

- **Practice address:** 3069 AMWILER RD, SUITE TWO, ATLANTA, GA 30360-2825
- **Practice address phone:** (678) 969-9920
- **Practice address fax:** (678) 969-9919
- **Mailing address:** 3069 AMWILER RD, SUITE 2, ATLANTA, GA 30360-2825
- **Mailing address phone:** (678) 969-9920
- **Mailing address fax:** (678) 969-9919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 038600 | GA | Yes |

## Other

- **Enumeration date:** 12/30/2011
- **Last updated:** 12/30/2011