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Individual

DR. MELISSA MERRILL MAGILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
297 COOPER RD, LOGANVILLE, GA 30052-2518
(678) 381-2630
(678) 381-2627
Mailing address
297 COOPER RD, LOGANVILLE, GA 30052-2518
(678) 381-2630
(678) 381-2627

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
057218
GA
208000000X
Pediatrics Physician
E13059
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200082724
MO
05
200902370A
OK
05
239398001
AR
05
452405206N
GA
Enumeration date
08/08/2006
Last updated
11/21/2025
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