Graduated: 2005
NPI: 1912251083
Practice Locations (2)
PRIVIA MEDICAL GROUP OF GEORGIA LLC
101 YORKTOWN DR
FAYETTEVILLE, GA 302141578
PRIVIA MEDICAL GROUP OF GEORGIA LLC
250 MARTIN LUTHER KING JR BLVD
MACON, GA 312013490
4783014111
Source: CMS National Downloadable File, September 2026.