Organization
WHITE FEATHER PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LARSEN (DIRECTOR OF CREDENTIALING)
(770) 874-5468
Entity
Organization
Contact information
Practice address
6601 WHITE FEATHER RD, JOSHUA TREE, CA 92252-6607
(760) 366-3711
Mailing address
5665 NEW NORTHSIDE DR STE 320, ATLANTA, GA 30328-5834
(770) 874-5400
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
07/20/2020
Last updated
08/19/2020
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