Individual
CORLISS A RUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1711 ATHENS HWY STE 500, GRAYSON, GA 30017-4210
(770) 982-2525
(770) 982-2526
Mailing address
2055C SCENIC HWY N # 187, SNELLVILLE, GA 30078-6105
(770) 982-2525
(770) 982-2526
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
049091
GA
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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