Healthcare Provider Details

I. General information

NPI: 1033263769
Provider Name (Legal Business Name): MEDNOW, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2709 AIRPORT RD SUITE 101
DALTON GA
30721-0252
US

IV. Provider business mailing address

2709 AIRPORT RD SUITE 101
DALTON GA
30721-0252
US

V. Phone/Fax

Practice location:
  • Phone: 706-275-4444
  • Fax: 706-275-6515
Mailing address:
  • Phone: 706-275-4444
  • Fax: 706-275-6515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: HOLLY BULLOCK
Title or Position: PRACTICE MANAGER
Credential:
Phone: 706-275-4444