Wickshire Canton Opco Llc

Specialty details in registry · Canton, GA

Call (770) 720-9669 Directions

At a glance

125 Riverstone Terrace, Canton, GA 30114

NPPES record updated Jan 2, 2020. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

125 Riverstone Terrace
Canton, GA 30114

Professional details: NPI, taxonomy & registry record

NPI1619516093

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 310400000X
Enumeration date: Jan 2, 2020
Record updated: Jan 2, 2020

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

310400000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

125 Riverstone Terrace
Canton, GA 30114

Phone: (770) 720-9669
Fax: (678) 880-3689

Mailing address

750 OLD HICKORY BLVD
BUILDING ONE SUITE 125
BRENTWOOD, TN 37027

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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