Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2007-10-20
- Last updated
- 2009-10-25
Licenses
- License GA
- 50331
- License GA
- 50331
Location
- Practice location
- 800 TOWNE PARK DR, SUIT 400,
- City
- RINCON GA
- Postal code
- 313265156
- Phone
- 912-826-3373
Organization contact
- Name
- KENNEDY OKERE
- Title
- Medical Director
- Phone
- 9128263373
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.