Graduated: 1995
NPI: 1639162340
Practice Locations (3)
THE SOUTHEAST PERMANENTE MEDICAL GROUP
3495 PIEDMONT RD NE
ATLANTA, GA 303051729
4043647206
T J SAMSON COMMUNITY HOSPITAL
1301 N RACE ST
GLASGOW, KY 421413454
2706514444
KENTUCKYONE HEALTH MEDICAL GROUP INC
1025 SAINT JOSEPH LN
LONDON, KY 407418345
6063302370
Source: CMS National Downloadable File, September 2026.