Graduated: 1981
NPI: 1487762084
Practice Locations (2)
PEACHTREE IMMEDIATE CARE FP, LLC
720 TRANSIT AVE, SUITE 101
CANTON, GA 301142544
7707207000
MILLENNIUM PHYSICIAN GROUP OF GEORGIA LLC
610 19TH ST
COLUMBUS, GA 319011528
7063227884
Source: CMS National Downloadable File, September 2026.