Organization · Type 2 NPI

Mixed Medical Media

Otolaryngology Physician · Stockbridge, GA

NPI number 1033090451 Active

Practice location

1106 Hospital Dr
Stockbridge, GA 30281-6381

Fax (678) 815-1548

Specialties and licenses

TaxonomyCodeLicense
Otolaryngology Physician Primary 207Y00000XNone listed

Otolaryngology Physician: An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injurie…

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About NPI 1033090451

Mixed Medical Media's National Provider Identifier is 1033090451, issued on Sep 11, 2025. The primary taxonomy on file is Otolaryngology Physician (207Y00000X), and the practice location is in Stockbridge, GA. The record was last updated on Sep 11, 2025.