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General NPI Number Information
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NPI Number | 1629510011
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Entity Type | Organization
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Legal Business Name | HUGGINS MEDICAL GROUP
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Dates
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Enumeration Date | 11/16/2016
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Last Update Date | 11/16/2016
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Provider Practice Location Address
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Address Line | 6934 BROAD ST
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-1604
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Country | US
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Telephone | 770-702-7728
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Fax |
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Provider Business Mailing Address
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Address Line | 6934 BROAD ST
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-1604
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Country | US
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Telephone | 770-702-7728
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MICHELLE A HUGGINS
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Credential | MD
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Telephone | 678-682-1131
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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 | 34368
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License Number State | GA
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