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General NPI Number Information
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NPI Number | 1699956631
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Entity Type | Organization
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Legal Business Name | NOWLIN FAMILY PRACTICE, PC
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 285 BOULEVARD NE STE 625
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City | ATLANTA
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State | GA
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Zip | 30312-4212
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Country | US
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Telephone | 404-265-0142
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Fax | 770-996-9528
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Provider Business Mailing Address
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Address Line | 285 BOULEVARD NE STE 625
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City | ATLANTA
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State | GA
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Zip | 30312-4212
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Country | US
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Telephone | 404-265-0142
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Fax | 770-996-9528
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Authorized Official
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Title or Position | MD
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Name | DR. PHILLIP W NOWLIN
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Credential | MD
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Telephone | 404-214-0162
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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 | 036588
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License Number State | GA
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