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Individual

DR. NEIL KINGSLEY GROFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD.

Contact information

Practice address
115 LEE BYRD RD, LOGANVILLE, GA 30052-2310
(770) 554-4717
(770) 554-4681
Mailing address
115 LEE BYRD RD, LOGANVILLE, GA 30052-2310
(770) 554-4717
(770) 554-4681

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
038504
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000638261C
GA
01
080180711
MEDICARE RAILROAD
GA
Enumeration date
07/24/2006
Last updated
10/13/2020
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