Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Pediatric & Family Wellness Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(770) 792-5261
Entity
Organization
Contact information
Practice address
1680 HOSPITAL SOUTH DR, AUSTELL, GA 30106-8110
(770) 634-2349
(770) 941-9919
Mailing address
1680 HOSPITAL SOUTH DR, AUSTELL, GA 30106-8110
(770) 634-2349
(770) 941-9919
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
GA
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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