Healthcare Provider Details

I. General information

NPI: 1588590459
Provider Name (Legal Business Name): NXTGEN BODIES MD ANTI-AGING CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11975 MORRIS RD STE 340
ALPHARETTA GA
30005-4444
US

IV. Provider business mailing address

11975 MORRIS RD STE 340
ALPHARETTA GA
30005-4444
US

V. Phone/Fax

Practice location:
  • Phone: 678-404-5137
  • Fax:
Mailing address:
  • Phone: 678-404-5137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CHAND GILL
Title or Position: CEO/FOUNDER
Credential:
Phone: 404-840-8838