Individual
NOBLE OGBU JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
80 GILMER ST SE, ATLANTA, GA 30303
(404) 550-6044
Mailing address
1517 ASHBROOKE TRCE, STONE MTN, GA 30083-1306
(404) 550-6044
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
11463
GA
207X00000X
Orthopaedic Surgery Physician
Primary
11463
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2021
Last updated
09/19/2024
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