Organization
GENESYS PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS LIGGION (OFFICE MANAGER)
(770) 987-2323
Entity
Organization
Contact information
Practice address
3598 PANOLA RD, LITHONIA, GA 30038-2731
(770) 987-2323
(770) 987-4145
Mailing address
3598 PANOLA RD, LITHONIA, GA 30038-2731
(770) 987-2323
(770) 987-4145
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
051567
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000960913D
—
GA
Enumeration date
06/17/2008
Last updated
06/17/2008
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