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Organization

WELLSTAR MEDICAL GROUP, LLC

Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Radiation Oncology
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
320 KENNESTONE HOSPITAL BLVD, SUITE LL1, MARIETTA, GA 30060-1161
(770) 793-7500
(770) 793-7985
Mailing address
320 KENNESTONE HOSPITAL BLVD, SUITE LL1, MARIETTA, GA 30060-1161
(770) 793-7500
(770) 793-7985

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
GA

Other

Enumeration date
03/23/2012
Last updated
11/19/2013
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