Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Physicians Group ENT
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
320 KENNESTONE HOSPITAL BLVD, SUITE 107, MARIETTA, GA 30060-1161
(770) 793-7613
(770) 793-7413
Mailing address
320 KENNESTONE HOSPITAL BLVD, SUITE 107, MARIETTA, GA 30060-1161
(770) 793-7613
(770) 793-7413
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
GA
Other
Enumeration date
01/31/2011
Last updated
01/31/2011
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