Organization
G MARC WETHERINGTON MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE BLACKMON (CREDENTIALING SPECIALIST)
(770) 748-0309
Entity
Organization
Contact information
Practice address
406 E 2ND AVE, ROME, GA 30161-3224
(706) 235-5119
(706) 235-5259
Mailing address
406 E 2ND AVE, ROME, GA 30161-3224
(706) 235-5119
(706) 235-5259
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
030690
GA
Other
Enumeration date
02/12/2009
Last updated
01/05/2010
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