Organization
PATRIOT HEALTHCARE OF GEORGIA, LLC
Active
Other names
PHC of GA Stone Mountain
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A. CULVER (ADMINISTRATOR)
(904) 825-4368
Entity
Organization
Contact information
Practice address
833 HAIRSTON ROAD, STONE MOUNTAIN, GA 30083
(770) 879-5553
(770) 879-5592
Mailing address
100 ARRICOLA AVENUE, ST. AUGUSTINE, FL 32080
(904) 825-4368
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
11/15/2018
Last updated
11/15/2018
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