Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar ENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(470) 644-0095
Entity
Organization
Contact information
Practice address
1790 MULKEY RD, SUITE 7, AUSTELL, GA 30106-1122
(770) 819-1435
(770) 819-3946
Mailing address
1790 MULKEY RD, SUITE 7, AUSTELL, GA 30106-1122
(770) 819-1435
(770) 819-3946
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
GA
Other
Enumeration date
09/30/2013
Last updated
11/19/2013
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