Organization
AGC PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN JOYAVE DO (CONTROLLER)
(706) 625-5900
Entity
Organization
Contact information
Practice address
5 MEDICAL DR NE, CARTERSVILLE, GA 30121-8003
(706) 625-5900
Mailing address
204 PROFESSIONAL CT SE, CALHOUN, GA 30701-7020
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN211260
GA
Other
Enumeration date
07/17/2014
Last updated
05/12/2020
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