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Organization
HUGHSTON CLINIC SOUTHEAST,PC
Active
Organization
HUGHSTON CLINIC SOUTHEAST,PC
Active
Parent organization
HUGHSTON CLINIC SOUTHEAST, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HUGHSTON CLINIC SOUTHEAST, PC
Authorized official
AMANDA FROMKIN (CREDENTIALING MGR)
(706) 494-3071
Entity
Organization
Contact information
Practice address
3443 DICKERSON PIKE STE 190, NASHVILLE, TN 37207-2533
(615) 860-1580
(615) 860-1541
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3008
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
NULL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
10/21/2020
Last updated
10/21/2020
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