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General NPI Number Information
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NPI Number | 1962594168
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Entity Type | Organization
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Legal Business Name | WEST GEORGIA GASTROENTEROLOGY ASSOCIATES,PC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 157 CLINIC AVE SUITE 201
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City | CARROLLTON
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State | GA
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Zip | 30117-4454
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Country | US
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Telephone | 770-214-2800
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Fax | 770-834-3321
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Provider Business Mailing Address
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Address Line | 157 CLINIC AVE STE 201
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City | CARROLLTON
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State | GA
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Zip | 30117-4454
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Country | US
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Telephone | 770-214-2800
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Fax | 770-214-2803
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JOHN ARLEDGE
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Credential | M.D.
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Telephone | 770-214-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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