Organization · Type 2 NPI
Graceol Corporation
Adult Medicine Physician · Conyers, GA
NPI number
1306373188
Active
Practice location
1035 Honey Creek Rd
Conyers, GA 30013
Fax (770) 922-9498
Mailing address
1035 Honey Creek Road
Conyers, GA 30013
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Medicine Physician Primary | 207QA0505X | None listed |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
About NPI 1306373188
Graceol Corporation's National Provider Identifier is 1306373188, issued on May 11, 2017. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Conyers, GA. The record was last updated on Jul 21, 2022.