Organization
WEST GEORGIA UROLOGY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC MORIN (OFFICE MANAGER)
(770) 834-6988
Entity
Organization
Contact information
Practice address
150 CLINIC AVE, SUITE 202, CARROLLTON, GA 30117-4402
(770) 834-6988
(770) 834-1090
Mailing address
150 CLINIC AVE, STE 202, CARROLLTON, GA 30117-4402
(770) 834-6988
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0438940001
PALMETTO GBA
GA
Enumeration date
09/20/2006
Last updated
01/14/2013
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