Organization
KENNESTONE HEART PHYSICIANS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE M DOYLE (MANAGER, PHYSICIAN SERVICES)
(678) 797-4113
Entity
Organization
Contact information
Practice address
120 STONEBRIDGE PKWY, SUITE 440, WOODSTOCK, GA 30189-3767
(770) 426-4721
Mailing address
355 TOWER RD NE, SUITE 300, MARIETTA, GA 30060-9408
(770) 426-4721
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
21937
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300025641K
—
GA
Enumeration date
12/21/2006
Last updated
04/10/2009
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