Organization
DAHLONEGA PEDIATRIC AND ADOLESCENT MEDICINE
Active
Organization
DAHLONEGA PEDIATRIC AND ADOLESCENT MEDICINE
Active
Other names
Dahlonega Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE CORN (PROVIDER/OWNER)
(706) 864-6700
Entity
Organization
Contact information
Practice address
1055 NORTH GROVE ST., DAHLONEGA, GA 30533
(706) 864-6700
(706) 864-2599
Mailing address
1055 NORTH GROVE ST, DAHLONEGA, GA 30533
(706) 864-6700
(706) 864-2599
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
RN068135
GA
261QR1300X
Rural Health Clinic/Center
Primary
11-8910
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000548369C
—
GA
Enumeration date
10/14/2011
Last updated
05/04/2015
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