Organization Name: | MOUNTAIN MEDICAL SPECIALISTS, PC |
NPI Number: | 1366504789 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | F STUART SANDERS (PRESIDENT) |
Mailing Address: | 207 Adams Dr Demorest |
State: | GA US |
Postal Code: | 305354501 |
Phone Number: | 7067545191 |
Fax Number: | 7067545191 |
NPI Enumeration Date: | 12/14/2006 |
NPI Last Update Date: | 07/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN124242 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |