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NPI 1255081642

NPI 1255081642 : SOPHIA KIRCHHOFF DO : CEDARTOWN, GA

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General NPI Number Information
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    NPI Number           |    1255081642
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    Entity Type          |    Individual 
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    Provider Name        |    SOPHIA KIRCHHOFF DO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/28/2022
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    Last Update Date     |    08/08/2025
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Provider Practice Location Address
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    Address Line         |    1168 N MAIN ST STE 110 
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    City                 |    CEDARTOWN
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    State                |    GA
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    Zip                  |    30125-2039
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    Country              |    US
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    Telephone            |    770-749-1005
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    Fax                  |    770-749-1119
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Provider Business Mailing Address
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    Address Line         |    PO BOX 12938 C/O CLINIC MANAGEMENT
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    City                 |    CALHOUN
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    State                |    GA
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    Zip                  |    30703
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    Country              |    US
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    Telephone            |    706-602-7800
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    Fax                  |    
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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       |    100570
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    License Number State |    GA
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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