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Organization
PROFESSIONAL PARK MEDICAL SERVICES, P.C.
Active
Organization
PROFESSIONAL PARK MEDICAL SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERSON TAYLOR GORDON MD (FAMILY PRACTICE MD)
(770) 832-6861
Entity
Organization
Contact information
Practice address
SUITE 202, 100 PROFESSIONAL PARK, CARROLLTON, GA 30117
(770) 832-6861
(770) 832-9432
Mailing address
SUITE 202, 100 PROFESSIONAL PARK, CARROLLTON, GA 30117
(770) 832-6861
(770) 832-9432
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/17/2006
Last updated
03/04/2016
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