Organization
HUBBARD PEDIATRIC GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOLLY L HUBBARD MD (OWNER/ PRESIDENT)
(770) 710-0117
Entity
Organization
Contact information
Practice address
4495 ATLANTA HWY, LOGANVILLE, GA 30052-6736
(770) 710-0117
Mailing address
309 BLUE CREEK LN, LOGANVILLE, GA 30052-7834
(770) 710-0110
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
064814
GA
Other
Enumeration date
05/05/2014
Last updated
05/05/2014
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