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Specialty details in registry · College Park, GA

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At a glance

6110 Hillandale Dr, College Park, GA 30349-4250

NPPES record updated Jul 21, 2009. 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

6110 Hillandale Dr
College Park, GA 30349-4250

Professional details: NPI, taxonomy & registry record

NPI1760612071

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 251E00000X
Enumeration date: Jul 21, 2009
Record updated: Jul 21, 2009

More registry details

Provider type: Organization · Type 2
Other reported name: <UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

251E00000X · Primary

License reported: CN0000016220 GA

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

Practice location

6110 Hillandale Dr
College Park, GA 30349-4250

Phone: (678) 600-3787

Mailing address

6110 HILLANDALE DR.

COLLEGEPARK, GA 303494250

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

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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