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General NPI Number Information
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NPI Number | 1033474184
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Entity Type | Individual
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Provider Name | LATAURA ATWELL-SMALL M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/05/2012
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 144 BILL CARRUTH PKWY STE 2200
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City | HIRAM
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State | GA
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Zip | 30141-3827
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Country | US
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Telephone | 470-956-4250
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Fax | 770-999-2761
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Provider Business Mailing Address
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Address Line | 144 BILL CARRUTH PKWY STE 2200
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City | HIRAM
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State | GA
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Zip | 30141-3827
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Country | US
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Telephone | 470-956-4250
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Fax | 770-999-2761
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME111325
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 96679
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License Number State | GA
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