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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 Allergy & Asthma
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
4480 N COOPER LAKE RD SE, STE. 101, SMYRNA, GA 30082-4622
(770) 333-2027
(770) 333-2031
Mailing address
4480 N COOPER LAKE RD SE, STE. 101, SMYRNA, GA 30082-4622
(770) 333-2027
(770) 333-2031
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
GA
Other
Enumeration date
03/03/2011
Last updated
11/19/2013
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