Individual
ERIC DANIEL WELLONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
775 POPLAR RD, SUITE 260, NEWNAN, GA 30265-8300
(404) 524-0095
(404) 658-9558
Mailing address
775 POPLAR RD, SUITE 260, NEWNAN, GA 30265-8300
(404) 524-0095
(404) 658-9558
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
049120
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00944347A
—
GA
Enumeration date
12/21/2005
Last updated
09/26/2012
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