Organization
NORTH FULTON PRIMARY CARE - WYLIE BRIDGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WESLEY O. JAMES (REGIONAL CFO, TENET)
(404) 265-5009
Entity
Organization
Contact information
Practice address
14205 HIGHWAY 92, SUITE 105, WOODSTOCK, GA 30188-7138
(678) 293-7854
(770) 740-8503
Mailing address
PO BOX 742595, ATLANTA, GA 30374-2595
(678) 293-7854
(770) 740-8503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
—
—
Other
Enumeration date
08/28/2013
Last updated
06/16/2016
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