NPI 1013158302

Mpm Group LLC

Organisation Family Medicine Physician Smyrna, GA

Practice location

Address: 2430 Herodian Way SE STE 210, Smyrna, GA 30080-2980
Phone: (770) 933-9951
Mailing address: 1135 Senoia Rd, Tyrone, GA 30290-1625

Authorised official

Name: Godfrey O Ilonzo
Title: President
Phone: (770) 692-8810

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Georgia →

Registry record

NPI: 1013158302
Entity type: Organization
NPI issued: 16 Mar 2009
Record last updated: 28 Jun 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.