PREMISE HEALTH OF GEORGIA MEDICAL, P.C. is a multi-specialty clinic center in Douglasville, GA. PREMISE HEALTH OF GEORGIA MEDICAL, P.C. NPI is 1013682996. The provider is registered as an organization entity type.
The provider Is Doing Business As City Of Douglasville.
The provider's business location address is:
6697 CHURCH ST
DOUGLASVILLE, GA
ZIP 30134-530
Phone: (336) 515-1313
Fax: (336) 804-5903
The provider's authorized official is Jon Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.
The CLIA number assigned to this NPI record is 11D2177891 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 8/12/2021 and was last updated on 8/24/2022.