Organization
PEACH STATE WOMEN'S HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY WALKER (PRACTICE ADMINISTRATOR)
(770) 898-1415
Entity
Organization
Contact information
Practice address
906 HAMPTON RD, MCDONOUGH, GA 30253-6570
(770) 898-1415
(770) 898-2887
Mailing address
906 HAMPTON RD, MCDONOUGH, GA 30253-6570
(770) 898-1415
(770) 898-2887
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
025822
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000607945A
—
GA
Enumeration date
05/29/2008
Last updated
05/29/2008
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