Organization
CORRECTMED LOCUST GROVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LINDA FAULKNER FNP (DIRECTOR OF OPERATIONS)
(770) 626-5740
Entity
Organization
Contact information
Practice address
4861 BILL GARDNER PKWY, SUITE 100, LOCUST GROVE, GA 30248-3644
(770) 626-5740
(770) 626-5750
Mailing address
PO BOX 538502, ATLANTA, GA 30353-8502
(770) 626-5740
(770) 626-5750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
053123
GA
Other
Enumeration date
03/14/2010
Last updated
09/24/2013
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