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Fountain Of Youth Md Llc
General Practice Physician in Atlanta, Georgia
NPI 1649527284

Fountain Of Youth Md Llc is a General Practice Physician based in Atlanta, GA. Fountain Of Youth Md Llc practices in Atlanta, GA. The NPI Number for Fountain Of Youth Md Llc is 1649527284 and holds a License No. (Georgia).

The current practice location address for Fountain Of Youth Md Llc is 200 Galleria Pkwy Se, Atlanta, GA and can be reached out via phone at 770-695-5500 and via fax at 800-814-3301.

Location: 200 Galleria Pkwy Se, Atlanta, GA, 30339-5918
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1649527284
Provider Name
Fountain Of Youth Md Llc
Credential
Provider Entity Type
Organization
Address
200 Galleria Pkwy Se, Atlanta, GA, 30339-5918
Phone Number
770-695-5500
Fax Number
800-814-3301
Provider Enumeration Date
08/14/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
200 Galleria Pkwy Se
City
Atlanta
State
Georgia
Zip
30339-5918
Phone Number
770-695-5500
Fax Number
800-814-3301
person
Provider Business Mailing Address Details
Address
200 Galleria Pkwy Se
City
Atlanta
State
Georgia
Zip
30339-5918
Phone Number
770-695-5500
Fax Number
800-814-3301
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
()
Definition
Definition to come...
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