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General NPI Number Information
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NPI Number | 1588284426
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Entity Type | Organization
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Legal Business Name | BRASELTON CLINICAL SERVICES
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 05/22/2020
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Provider Practice Location Address
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Address Line | 5745 OLD WINDER HWY STE G
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City | BRASELTON
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State | GA
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Zip | 30517-1637
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Country | US
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Telephone | 678-327-8650
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Fax | 770-967-4005
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Provider Business Mailing Address
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Address Line | 3841 ROXFIELD DR
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City | BUFORD
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State | GA
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Zip | 30518-8507
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Country | US
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Telephone | 678-327-8650
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BHARAT K SINOJIA
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Credential |
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Telephone | 678-714-0054
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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 |
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License Number State |
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