Organization
ROCDALE PHYSICIAN PRACTICES, LLC
Active
Other names
Premier Healthcare Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY D. VAUGHN (VICE PRESIDENT)
(615) 372-8505
Entity
Organization
Contact information
Practice address
5154 COOK ST NE, COVINGTON, GA 30014-2630
(770) 788-1778
(770) 788-1285
Mailing address
PO BOX 116202, ATLANTA, GA 30368-6202
(770) 922-0734
(770) 922-0734
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
070244
GA
207R00000X
Internal Medicine Physician
Primary
070244
GA
Other
Enumeration date
07/30/2013
Last updated
11/04/2013
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