| Organization Name: | FIRST DOCTORS WEIGHT LOSS |
| NPI Number: | 1104285980 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | T. WAYNE BLOODWORTH (PRESIDENT) |
| Mailing Address: | 6794 Bill Carruth Pkwy Hiram |
| State: | GA US |
| Postal Code: | 301413770 |
| Phone Number: | 6785675918 |
| Fax Number: | |
| NPI Enumeration Date: | 02/22/2016 |
| NPI Last Update Date: | 02/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 114757 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |