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NPI Code Detail

MEDICARE: AYLO HEALTH, LLC

MEDICARE: AYLO HEALTH, 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
1207Q00000XFamily Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CC6012OTHERGARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1061407OTHERGABC/BS OF GA GROUP

General Provider Information

NPI Number : 1710929914
Entity Type Code : Organization
Provider Name (Legal Business Name) : AYLO HEALTH, LLC
Provider Business Mailing Address
First Line : PO BOX 746765
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6765
Country : US
Telephone Number : 770-914-0116
Fax Number : 770-955-4278
Provider Business Practice Location Address
First Line : 3758 HIGHWAY 42 S
Second Line :
City : LOCUST GROVE
State : GA
Zip : 30248-3653
Country : US
Telephone Number : 678-561-9430
Fax Number : 770-914-1070
Authorized Official
Title or Position : CEO
Name : NICHOLAS WILLIAMS
Credential :
Telephone Number : 770-914-0116
Provider Enumeration Date : 06/12/2006
Last Update Date : 01/14/2026

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Directions to “AYLO HEALTH, LLC ” Practice Location

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