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General NPI Number Information
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NPI Number | 1053584722
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Entity Type | Organization
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Legal Business Name | SNAPFINGER WOODS FAMILY PRACTICE GROUP
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 12/29/2022
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Provider Practice Location Address
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Address Line | 5071 SNAPFINGER WOODS DR
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City | DECATUR
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State | GA
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Zip | 30035-4019
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Country | US
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Telephone | 770-981-0600
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Fax | 770-981-0677
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Provider Business Mailing Address
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Address Line | 5071 SNAPFINGER WOODS DR
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City | DECATUR
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State | GA
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Zip | 30035-4019
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Country | US
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Telephone | 770-981-0600
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Fax | 770-981-0677
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Authorized Official
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Title or Position | CEO
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Name | DR. MARIA LATANYA WALKER
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Credential |
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Telephone | 770-981-0600
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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 | 025306
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License Number State | GA
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