Organization
CORNERSTONE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC JENSEN M.D. (PRESIDENT)
(706) 226-3139
Entity
Organization
Contact information
Practice address
914 VISTA DRIVE, DALTON, GA 30721-8654
(706) 226-3139
(706) 278-6606
Mailing address
914 VISTA DRIVE, DALTON, GA 30721-8654
(706) 226-3139
(706) 278-6606
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/17/2005
Last updated
08/19/2024
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