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Organization

WELLSTAR MEDICAL GROUP, LLC

Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar South Cobb 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
1700 HOSPITAL SOUTH DR, SUITE 500, AUSTELL, GA 30106-6810
(770) 941-7717
(770) 948-9729
Mailing address
1700 HOSPITAL SOUTH DR, SUITE 500, AUSTELL, GA 30106-6810
(770) 941-7717
(770) 948-9729

Taxonomy

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

Other

Enumeration date
02/08/2011
Last updated
11/19/2013
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