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Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Pediatric After Hours Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(470) 644-0095
Entity
Organization
Contact information
Practice address
1180 ERNEST W BARRETT PKWY NW, SUITE 102B, KENNESAW, GA 30144-4534
(678) 354-2273
(770) 794-6837
Mailing address
1180 ERNEST W BARRETT PKWY NW, SUITE 102B, KENNESAW, GA 30144-4534
(678) 354-2273
(770) 794-6837
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
GA
261QU0200X
Urgent Care Clinic/Center
—
GA
Other
Enumeration date
04/23/2014
Last updated
06/10/2015
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