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Organization
KENNESAW FAMILY PHYSICIANS PC
Active
Organization
KENNESAW FAMILY PHYSICIANS PC
Active
Other names
Main Street Family Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE H. KELLER (OFFICE MANAGER)
(770) 422-1400
Entity
Organization
Contact information
Practice address
4791 S MAIN ST, ACWORTH, GA 30101-5324
(770) 422-1400
(678) 290-6728
Mailing address
4791 S MAIN ST, ACWORTH, GA 30101-5324
(770) 422-1400
(678) 290-6728
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
581584420
GA
Other
Enumeration date
01/30/2007
Last updated
10/22/2012
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