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Organization

SMOKERISE FAMILY MEDICAL ASSOC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL LESLEY BARON D.O. (FAMILY PHYSICIAN/PRESIDENT)
(770) 469-1711
Entity
Organization

Contact information

Practice address
1505 LILBURN STONE MOUNTAIN RD, STE 100, STONE MOUNTAIN, GA 30087-1857
(770) 469-1711
(770) 469-1837
Mailing address
1505 LILBURN STONE MOUNTAIN RD, STE 100, STONE MOUNTAIN, GA 30087-1857
(770) 469-1711
(770) 469-1837

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0033273
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00474779A
GA
Enumeration date
12/03/2010
Last updated
12/03/2010
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