Medical school: MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduated: 1984
NPI: 1932210648
Practice Locations (3)
1120 15TH ST
AUGUSTA, GA 309120006
635 BLANCHARD RD
Evans, GA 308095867
PO BOX, SUITE 670747
Marietta, GA 300660130
Source: CMS National Downloadable File, September 2026.