Organization
24 ON PHYSICIANS, P.C.
Active
Organization
24 ON PHYSICIANS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN A. FULLER (VP/SECRETARY)
(770) 740-0895
Entity
Organization
Contact information
Practice address
11 UPPER RIVERDALE RD, RIVERDALE, GA 30274-2600
(770) 897-7107
(770) 897-7109
Mailing address
PO BOX 403631, ATLANTA, GA 30384-3631
(770) 740-0895
(770) 740-0896
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/13/2009
Last updated
11/13/2009
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