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General NPI Number Information
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NPI Number | 1912875402
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Entity Type | Organization
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Legal Business Name | MIXED MEDICAL MEDIA
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 1106 HOSPITAL DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281
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Country | US
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Telephone | 678-902-9495
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Fax | 678-815-1548
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Provider Business Mailing Address
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Address Line | 1106 HOSPITAL DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281
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Country | US
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Telephone | 678-902-9495
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Fax | 678-815-1548
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Authorized Official
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Title or Position | OWNER
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Name | AARON FLETCHER
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Credential |
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Telephone | 678-902-9495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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