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NPI Code Detail

MEDICARE: WASHINGTON WILKES EMERGENCY PHYSICIANS LLC

MEDICARE: WASHINGTON WILKES EMERGENCY PHYSICIANS 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
1207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1891725719
Entity Type Code : Organization
Provider Name (Legal Business Name) : WASHINGTON WILKES EMERGENCY PHYSICIANS LLC
Provider Business Mailing Address
First Line : 13737 NOEL RD
Second Line : STE 1600
City : DALLAS
State : TX
Zip : 75240-1331
Country : US
Telephone Number : 469-401-2386
Fax Number : 214-712-2444
Provider Business Practice Location Address
First Line : 120 GORDON ST
Second Line : EMERGENCY DEPARTMENT
City : WASHINGTON
State : GA
Zip : 30673-1602
Country : US
Telephone Number : 706-678-2151
Fax Number :
Authorized Official
Title or Position : EXEC. VICE PRESIDENT
Name : ROSS RONAN
Credential :
Telephone Number : 469-401-2386
Provider Enumeration Date : 07/04/2006
Last Update Date : 04/16/2014

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Directions to “WASHINGTON WILKES EMERGENCY PHYSICIANS LLC ” Practice Location

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