Organization
BALL GROUND FAMILY PRACTICE,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES L COSTER DO (PHYSICIAN)
(770) 735-6755
Entity
Organization
Contact information
Practice address
255 GILMER FERRY RD, BALL GROUND, GA 30107-2908
(770) 735-6755
(770) 735-4528
Mailing address
PO BOX 127, BALL GROUND, GA 30107-0127
(770) 735-6755
(770) 735-4528
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
045754
GA
Other
Enumeration date
02/22/2008
Last updated
02/22/2008
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