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MALLORY MCCORD AYCOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
750 TOWNPARK LANE, KAISER PERMANENTE TOWNPARK MEDICAL CENTER, KENNESAW, GA 30144
(404) 256-9692
Mailing address
3495 PIEDMONT ROAD, NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305
(404) 364-7070

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006613
GA
363A00000X
Physician Assistant
6613
GA

Other

Enumeration date
09/22/2011
Last updated
01/29/2014
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