# GATEWOOD CLINIC AND MEDSPA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871398842
- **Authorized official:** KIMBERLY MICHELE PIERSON (OWNER)
- **Authorized official phone:** (770) 685-0718

## Contact information

- **Practice address:** 715 VILLAGE SQUARE DR, STONE MOUNTAIN, GA 30083-3379
- **Practice address phone:** (470) 823-3051
- **Practice address fax:** (678) 615-2314
- **Mailing address:** 2989 WILSONE PL, STONE MOUNTAIN, GA 30083-3379
- **Mailing address phone:** (770) 685-0718
- **Mailing address fax:** (678) 615-2314

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207SG0201X | Clinical Genetics (M.D.) Physician | — | NULL | Yes |
| 207SG0201X | Clinical Genetics (M.D.) Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/14/2025
- **Last updated:** 05/07/2025