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Individual

PHILLIP W NOWLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
115 AMBULANCE DR, CARROLLTON, GA 30117
(404) 759-7535
(770) 834-7100
Mailing address
115 AMBULANCE DR, CARROLLTON, GA 30117-3855
(404) 759-7535
(770) 834-7100

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
036588
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000545003F
GA
Enumeration date
07/11/2005
Last updated
03/24/2009
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