Organization
PREMISE HEALTH OF GEORGIA MEDICAL, P.C.
Active
Other names
Shaw Family Health Center Plant WD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON LEIZMAN MD (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
2305 ABUTMENT RD, DALTON, GA 30721-4881
(706) 532-2588
(706) 532-2589
Mailing address
5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/27/2020
Last updated
08/24/2022
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