Organization
PHYSICIANS' IMMEDIATE MED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA P HART (BRANCH MANAGER/CREDENTIALING)
(770) 505-3000
Entity
Organization
Contact information
Practice address
10905 HAYNES BRIDGE RD, ALPHARETTA, GA 30022-4807
(770) 505-3000
(770) 753-4228
Mailing address
10905 HAYNES BRIDGE RD, ALPHARETTA, GA 30022-4807
(770) 505-3000
(770) 753-4228
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/07/2006
Last updated
08/22/2020
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