Individual
MR. FORREST CLARK CANTRELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3515 DALLAS HWY, STE C, MARIETTA, GA 30064
(770) 943-9150
(770) 212-0276
Mailing address
5200 DALLAS HWY, STE 200, POWDER SPRINGS, GA 30127-6318
(770) 943-9150
(770) 212-0276
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
028948
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000382489G
—
GA
05
—
00382489A
—
GA
Enumeration date
05/27/2006
Last updated
05/10/2023
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