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Organization
PREMISE HEALTH OF GEORGIA MEDICAL, P.C.
Active
Organization
PREMISE HEALTH OF GEORGIA MEDICAL, P.C.
Active
Other names
Shaw Family Health Center Plant 4
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON LEIZMAN MD (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
2225 S HAMILTON ST, DALTON, GA 30721-4975
(706) 532-4051
(706) 532-4052
Mailing address
5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/27/2020
Last updated
08/24/2022
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