MEDICARE: WELLSTAR MEDICAL GROUP, LLC

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	261QU0200X	Urgent Care Clinic/Center		GA

General Provider Information

NPI Number	:	1669767364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLSTAR MEDICAL GROUP, LLC

Provider Business Mailing Address
First Line	:	4480 N COOPER LAKE RD SE
Second Line	:	SUITE 100
City	:	SMYRNA
State	:	GA
Zip	:	30082-4622
Country	:	US
Telephone Number	:	770-333-1300
Fax Number	:	770-432-8312

Provider Business Practice Location Address
First Line	:	4480 N COOPER LAKE RD SE
Second Line	:	SUITE 100
City	:	SMYRNA
State	:	GA
Zip	:	30082-4622
Country	:	US
Telephone Number	:	770-333-1300
Fax Number	:	770-432-8312

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR OF FINANCE
Name	:	MRS. NICOLE ASHE
Credential	:
Telephone Number	:	770-792-5261

Provider Enumeration Date	:	06/10/2011
Last Update Date	:	06/10/2011

Similar Medicare Providers

1205823184 — MICHAEL D SIMPSON M.D.
Practice Location Address:

4480 N COOPER LAKE RD SE
SMYRNA, GA
30082-4622

Practice Phone: 770-333-1300
Practice Fax: 770-432-8312

1841245719 — SURABHI ARJUNAN MD
Practice Location Address:

4480 N COOPER LAKE RD SE , SUITE 201
SMYRNA, GA
30082-4622

Practice Phone: 770-333-2035
Practice Fax:

1528386349 — WELLSTAR RHEUMATOLOGY, LLC
Practice Location Address:

4480 N COOPER LAKE RD SE , SUITE 201
SMYRNA, GA
30082-4622

Practice Phone: 770-792-5275
Practice Fax: 770-941-6466

1538467303 — WELLSTAR MEDICAL GROUP, LLC
Practice Location Address:

4480 N COOPER LAKE RD SE , STE. 101
SMYRNA, GA
30082-4622

Practice Phone: 770-333-2027
Practice Fax: 770-333-2031

1023301033 — WELLSTAR MEDICAL GROUP, LLC
Practice Location Address:

4480 N COOPER LAKE RD SE , SUITE 201
SMYRNA, GA
30082-4622

Practice Phone: 770-333-2035
Practice Fax: 770-333-2059

1851243877 — HARDMAN CONSULTING INCORPORATED
Practice Location Address:

330 COVERED BRIDGE PL SW
SMYRNA, GA
30082-3603

Practice Phone: 404-536-4030
Practice Fax:

Directions to “WELLSTAR MEDICAL GROUP, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.