Individual
S BROOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
(404) 616-1000
Mailing address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
045730
GA
Other
Enumeration date
05/06/2008
Last updated
02/05/2013
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