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Individual

ROBERT C. WIRT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
597 S ENOTA DR NE, GAINESVILLE, GA 30501-2545
(770) 219-7777
(770) 219-7778
Mailing address
601 S ENOTA DR NE, SUITE Q, GAINESVILLE, GA 30501-2400
(770) 219-8420
(770) 219-8440

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
026686
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00365538C
GA
Enumeration date
08/23/2005
Last updated
02/19/2010
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