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Organization

WELLSTAR BI-COUNTY ENT, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE ASHE (ASSISTANT VP OF FINANCE)
(770) 792-5261
Entity
Organization

Contact information

Practice address
6002 PROFESSIONAL PKWY, SUITE 100, DOUGLASVILLE, GA 30134-5600
(770) 949-4200
(770) 949-5553
Mailing address
6002 PROFESSIONAL PKWY, SUITE 100, DOUGLASVILLE, GA 30134-5600
(770) 949-4200
(770) 949-5553

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary

Other

Enumeration date
06/15/2010
Last updated
03/23/2011
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