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Organization

WELLSTAR MEDICAL GROUP, LLC

Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar North Douglas Ob/Gyn
Organization subpart
Yes

Provider details

NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(470) 644-0095
Entity
Organization

Contact information

Practice address
6095 PROFESSIONAL PKWY, SUITE A-210, DOUGLASVILLE, GA 30134-5607
(770) 949-4188
(770) 949-1614
Mailing address
6095 PROFESSIONAL PKWY, SUITE A-210, DOUGLASVILLE, GA 30134-5607
(770) 949-4188
(770) 949-1614

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
GA

Other

Enumeration date
02/08/2011
Last updated
11/18/2013
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