Individual
THEOLYN N PRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 HOSPITAL BLVD STE 420, ROSWELL, GA 30076
(704) 249-7327
(770) 421-0228
Mailing address
2500 HOSPITAL BLVD STE 420, ROSWELL, GA 30076-4919
(704) 249-7327
(770) 421-0228
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
45827
MN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
52769
CO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
80819
GA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
ME110622
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003983700
—
MN
05
—
35294500
—
WI
05
—
ENROLLED
—
IA
01
—
P00042740
RAILROAD MEDICARE
MN
Enumeration date
01/23/2006
Last updated
09/30/2019
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