Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Gynecologic Oncology
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(470) 644-0095
Entity
Organization
Contact information
Practice address
1700 HOSPITAL SOUTH DR, SUITE 102, AUSTELL, GA 30106-6810
(770) 792-6262
(678) 398-1929
Mailing address
1700 HOSPITAL SOUTH DR, SUITE 102, AUSTELL, GA 30106-6810
(770) 792-6262
(678) 398-1929
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
—
GA
Other
Enumeration date
04/08/2013
Last updated
11/19/2013
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