Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Bi-County ENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(770) 792-5261
Entity
Organization
Contact information
Practice address
1790 MULKEY RD, AUSTELL, GA 30106-1122
(770) 819-1435
(770) 819-3946
Mailing address
1790 MULKEY RD, AUSTELL, GA 30106-1122
(770) 819-1435
(770) 819-3946
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
GA
Other
Enumeration date
01/31/2011
Last updated
01/31/2011
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