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NPI Code Detail

MEDICARE: GEORGIA FORREST MD

MEDICARE: GEORGIA FORREST MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician271138-1NY
2390200000XStudent in an Organized Health Care Education/Training Program
3207Q00000XFamily Medicine Physician72267GA

General Provider Information

NPI Number : 1366767444
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGIA FORREST MD
Provider Business Mailing Address
First Line : 4250 BROWNSVILLE RD
Second Line :
City : POWDER SPRINGS
State : GA
Zip : 30127-2559
Country : US
Telephone Number : 678-567-8000
Fax Number : 770-439-3555
Provider Business Practice Location Address
First Line : 4250 BROWNSVILLE RD
Second Line :
City : POWDER SPRINGS
State : GA
Zip : 30127-2559
Country : US
Telephone Number : 678-567-8000
Fax Number : 770-439-3555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2010
Last Update Date : 10/29/2019

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Directions to “ GEORGIA FORREST MD” Practice Location

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