Organization
EPITOME PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENETTE ST-GOURDIN MD (OWNER)
(912) 695-6080
Entity
Organization
Contact information
Practice address
631 CAMPBELL HILL ST NW STE 200, MARIETTA, GA 30060-1390
(770) 727-6124
Mailing address
631 CAMPBELL HILL ST NW STE 200, MARIETTA, GA 30060-1390
(770) 727-6124
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/24/2024
Last updated
12/04/2024
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