Individual
MALLORY WHITSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-4500
Mailing address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-4500
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
110551
GA
363AS0400X
Surgical Physician Assistant
5315
CT
Other
Enumeration date
05/30/2018
Last updated
08/01/2022
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