Organization Name: | TAKE CARE HEALTH GEORGIA, P.C. |
NPI Number: | 1043409964 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBORAH HEGG (ASSISTANT SECRETARY) |
Mailing Address: | 2779 Cobb Pkwy Nw Kennesaw |
State: | GA US |
Postal Code: | 301523437 |
Phone Number: | 8559254733 |
Fax Number: | 2177092345 |
NPI Enumeration Date: | 10/16/2007 |
NPI Last Update Date: | 12/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |