Healthcare Provider Details

I. General information

NPI: 1912956251
Provider Name (Legal Business Name): 24 ON PHYSICIANS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 TURNER MCCALL BLVD SW
ROME GA
30165-5621
US

IV. Provider business mailing address

PO BOX 19108
BELFAST ME
04915-4086
US

V. Phone/Fax

Practice location:
  • Phone: 770-274-0468
  • Fax: 404-806-4334
Mailing address:
  • Phone: 770-274-0482
  • Fax: 770-740-0896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DAN A. FULLER
Title or Position: SECRETARY
Credential:
Phone: 770-274-0482