Organization
WELLSTAR PHYSICIANS GROUP ENT, LLC
Active
Parent organization
WELLSTAR HEALTH SYSTEM, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR HEALTH SYSTEM, INC.
Authorized official
NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(770) 792-5261
Entity
Organization
Contact information
Practice address
504 W MEMORIAL DR, DALLAS, GA 30132-4119
(770) 505-7190
(770) 793-7413
Mailing address
504 W MEMORIAL DR, DALLAS, GA 30132-4119
(770) 505-7190
(770) 793-7413
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
07/14/2008
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