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General NPI Number Information
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NPI Number | 1942376918
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Entity Type | Organization
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Legal Business Name | COVENANT MULTISPECIALTY GROUP
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 11/14/2011
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Provider Practice Location Address
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Address Line | 4106 COLUMBIA RD SUITE 103
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City | MARTINEZ
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State | GA
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Zip | 30907-1450
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Country | US
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Telephone | 706-863-1440
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Fax | 706-863-5418
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Provider Business Mailing Address
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Address Line | 4106 COLUMBIA RD SUITE 103
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City | MARTINEZ
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State | GA
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Zip | 30907-1450
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Country | US
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Telephone | 706-863-1440
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Fax | 706-863-5418
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALAN GRANT GETTS
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Credential | M.D.
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Telephone | 706-868-3251
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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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Taxonomy #2
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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