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Individual

ANDREW FORT GODFREY-KITTLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
49 JESSE HILL JR DR SE, ATLANTA, GA 30303-3049
(404) 778-1415
(404) 778-1401
Mailing address
49 JESSE HILL JR DR SE, ATLANTA, GA 30303-3049
(404) 778-1415
(404) 778-1401

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
004617
GA
208000000X
Pediatrics Physician
Primary
069199
GA
390200000X
Student in an Organized Health Care Education/Training Program
GA

Other

Enumeration date
04/07/2010
Last updated
02/08/2013
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