Organization
GWINNETT PEDIATRIC PARTNERS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE KATSITADZE M.D. (PRESIDENT)
(770) 923-6400
Entity
Organization
Contact information
Practice address
4120 FIVE FORKS TRICKUM RD SW, STE 102, LILBURN, GA 30047-8975
(770) 923-6400
(770) 564-1967
Mailing address
PO BOX 4207, MACON, GA 31208-4207
(770) 923-6400
(770) 564-1697
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
09/10/2014
Last updated
09/15/2014
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