Individual
MARIA JOCELYN ORIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
157 CLINIC AVE, STE 203, CARROLLTON, GA 30117
(770) 832-0429
(770) 838-9108
Mailing address
157 CLINIC AVE, STE 203, CARROLLTON, GA 30117
(770) 832-0429
(770) 838-9108
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
044561
GA
207RN0300X
Nephrology Physician
Primary
044561
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000779369G
—
GA
01
—
202I395238
MEDICARE PTAN
GA
Enumeration date
07/14/2006
Last updated
09/27/2016
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