Organization
ALPHA INTERNAL MEDICINE, LLC
Active
Other names
Alpha Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETSY S HORTON M.D. (PRESIDENT)
(770) 719-5490
Entity
Organization
Contact information
Practice address
745 GLYNN ST S, FAYETTEVILLE, GA 30214-2049
(770) 719-5490
Mailing address
PO BOX 142459, FAYETTEVILLE, GA 30214-6515
(770) 719-5490
(770) 719-3113
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
720353
GA
207R00000X
Internal Medicine Physician
Primary
040693
GA
207R00000X
Internal Medicine Physician
047760
GA
207R00000X
Internal Medicine Physician
053123
GA
207R00000X
Internal Medicine Physician
055270
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00753519B
—
GA
05
—
510368765A
—
GA
Enumeration date
08/04/2006
Last updated
04/01/2014
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