Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Cobb Surgical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(770) 792-5261
Entity
Organization
Contact information
Practice address
1810 MULKEY RD, SUITE 105, AUSTELL, GA 30106-1151
(770) 944-0686
(770) 948-9341
Mailing address
1810 MULKEY RD, SUITE 105, AUSTELL, GA 30106-1151
(770) 944-0686
(770) 948-9341
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
GA
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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