Organization
ANESTHESIA CONSULTANTS OF GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCUS POLK M.D. (OWNER/PRESIDENT)
(404) 403-4567
Entity
Organization
Contact information
Practice address
3974 GLEN PARK DR, LITHONIA, GA 30038-3694
(404) 403-4567
Mailing address
3974 GLEN PARK DR, LITHONIA, GA 30038-3694
(404) 403-4567
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
040758
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003109750A
—
GA
Enumeration date
01/11/2012
Last updated
01/11/2012
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