Organization
PHYSICIANS' IMMEDIATE MED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA P HART (BRANCH MANAGER/CREDENTIALING)
(770) 476-3000
Entity
Organization
Contact information
Practice address
3551 SATELLITE BLVD, DULUTH, GA 30096-4646
(770) 476-3000
(770) 476-4066
Mailing address
3551 SATELLITE BLVD, DULUTH, GA 30096-4646
(770) 476-3000
(770) 476-4066
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/09/2006
Last updated
08/22/2020
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