Graduated: 1996
NPI: 1093724015
Practice Locations (2)
PRIVIA MEDICAL GROUP OF GEORGIA LLC
101 YORKTOWN DR
FAYETTEVILLE, GA 302141578
PRIVIA MEDICAL GROUP OF GEORGIA LLC
747 S HILL ST
GRIFFIN, GA 302244830
7702285407
Source: CMS National Downloadable File, September 2026.