Organization
MOULTRIE MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MOULTRIE MD (OWNER)
(256) 302-3505
Entity
Organization
Contact information
Practice address
2970 CLAIRMONT RD NE STE 210, BROOKHAVEN, GA 30329-4414
(256) 302-3505
Mailing address
2847 CEDAR CANYON CT NE, ATLANTA, GA 30345-4021
(256) 302-3505
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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