Organization
ZOE CENTER FOR PEDIATRIC & ADOLESCENT HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE KONG MD (OWNER)
(706) 938-0990
Entity
Organization
Contact information
Practice address
210 HANNAHS MILL RD, THOMASTON, GA 30286-2801
(706) 938-0990
Mailing address
959 17TH ST STE B, COLUMBUS, GA 31901-1984
(706) 507-9127
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
39388
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003122332A
—
GA
Enumeration date
02/22/2012
Last updated
03/30/2020
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