Stillwell Medical Group
NPI #1659414175 in Loganville, Georgia
Provider Information
- NPI Number
- 1659414175
- Entity Type
- Organization
- Organization Name
- Stillwell Medical Group
- Primary Specialty
- Physician Assistant
- Enumeration Date
- Feb 14, 2007
- Last Updated
- Feb 4, 2016
Practice Location
- Address
- 4160 LOGAN DR UNIT 1596
- City
- Loganville
- State
- Georgia
- ZIP Code
- 30052-9516
- Phone
- (678) 557-0207
Authorized Official
- Name
- LATONDRA DENISE BARKER
- Title
- MANAGER
- Phone
- (678) 557-0207
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist, Other - Surgical Assistant — Surgical Assistant |
| Physician Assistant |
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