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General NPI Number Information
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NPI Number | 1295992022
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Entity Type | Organization
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Legal Business Name | MURRAY INTERNAL MEDICINE, PC
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 106 HOSPITAL DR
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City | CHATSWORTH
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State | GA
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Zip | 30705-2070
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Country | US
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Telephone | 706-695-1488
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Fax | 706-422-9586
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Provider Business Mailing Address
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Address Line | 106 HOSPITAL DR
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City | CHATSWORTH
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State | GA
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Zip | 30705-2070
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Country | US
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Telephone | 706-695-1488
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Fax | 706-422-9586
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MANDY LYNN FONTAINE
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Credential |
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Telephone | 706-695-1488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 035479
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License Number State | GA
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