Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 026601 | GA |
NPI | 1225082282 |
---|---|
Provider Name | Judy C Mills |
First Address | Marietta, GA 30062 |
Second Address | Atlanta, GA 30342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 18/11/2007 |