Organization
ELITE MEDICAL PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOUISE A BROWN (OFFICE MANAGER)
(678) 534-0452
Entity
Organization
Contact information
Practice address
2892 MOUNTAIN INDUSTRIAL BLVD, TUCKER, GA 30084-3014
(678) 534-0452
(678) 534-1534
Mailing address
2892 MOUNTAIN INDUSTRIAL BLVD, P.O. BOX 201, TUCKER, GA 30084-3014
(678) 534-0452
(678) 534-1534
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
038076
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000596626F
—
GA
Enumeration date
05/10/2007
Last updated
06/25/2010
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