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Contact Information

WELLSTAR MEDICAL GROUP, LLC
1700 HOSPITAL SOUTH DR
SUITE 102
AUSTELL, GA30106-6810
 Phone: 770-792-6262
 Fax: 678-398-1929
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gynecologic Oncology

207VX0201X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for WELLSTAR MEDICAL GROUP, LLC

NPI Number 1669815817
LBN Legal business name WELLSTAR MEDICAL GROUP, LLC
Authorized official NICOLE ASHE - (EXECUTIVE DIRECTOR OF FINANCE)
Entity Organization
Organization subpart 1 Yes
Enumeration date 04/08/2013
Last updated 11/19/2013 - About 13 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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