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General NPI Number Information
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NPI Number | 1174285043
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Entity Type | Organization
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Legal Business Name | DOBBS FAMILY HEALTH AND WELLNESS CENTER
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Dates
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Enumeration Date | 10/08/2021
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Last Update Date | 10/08/2021
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Provider Practice Location Address
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Address Line | 1810 MULKEY RD STE 200
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City | AUSTELL
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State | GA
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Zip | 30106-1150
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Country | US
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Telephone | 678-772-1910
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Fax |
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Provider Business Mailing Address
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Address Line | 2688 MOON CABIN DR
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-3791
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Country | US
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Telephone | 678-772-1910
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RENEKA L DOBBS-JACKSON
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Credential | MD
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Telephone | 678-772-1910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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