NPI 1164698486

S Broom

Practitioner General Practice Physician Atlanta, GA

Practice location

Address: 80 Jesse Hill Jr Dr SE, Atlanta, GA 30303-3031
Phone: (404) 616-1000

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 045730 (GA)

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Registry record

NPI: 1164698486
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 May 2008
Record last updated: 5 Feb 2013

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.