MEDICARE: HEATHER MOLINA

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
1	207Q00000X	Family Medicine Physician	RN295250	GA

General Provider Information

NPI Number	:	1659160794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER MOLINA

Provider Business Mailing Address
First Line	:	15 CEDARTOWN ST SW
Second Line	:
City	:	CAVE SPRING
State	:	GA
Zip	:	30124-2703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 CEDARTOWN ST SW
Second Line	:
City	:	CAVE SPRING
State	:	GA
Zip	:	30124-2703
Country	:	US
Telephone Number	:	706-749-4900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2025
Last Update Date	:	05/05/2025

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Directions to “ HEATHER MOLINA ” Practice Location

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