Phoenix Medical Office at College Park,llc
NPI #1396033064 in College Park, Georgia
Provider Information
- NPI Number
- 1396033064
- Entity Type
- Organization
- Organization Name
- Phoenix Medical Office at College Park,llc
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Jul 15, 2011
- Last Updated
- Dec 11, 2012
Practice Location
- Address
- 1631 PHOENIX BLVD STE 4
- City
- College Park
- State
- Georgia
- ZIP Code
- 30349-5545
- Phone
- (678) 788-8950
Authorized Official
- Name
- KELVIN MAURICE HAMNER, MD
- Title
- OWNER/MD
- Phone
- (678) 788-8950
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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