Individual
IRIS ALTAGRACIA CASTRO-REVOREDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 S 8TH ST, GRIFFIN, GA 30224-4213
(770) 467-6314
(770) 467-6324
Mailing address
13957 WOOLSEY RD, HAMPTON, GA 30228-2246
(770) 703-6601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
056984
GA
208M00000X
Hospitalist Physician
Primary
56984
GA
Other
Enumeration date
10/10/2006
Last updated
12/03/2019
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