Provider Demographics
NPI:1750132072
Name:WOUND SOLUTIONS OF GEORGIA LLC
Entity type:Organization
Organization Name:WOUND SOLUTIONS OF GEORGIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMEEL
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-830-1836
Mailing Address - Street 1:7702B HAMPTON PL
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-6770
Mailing Address - Country:US
Mailing Address - Phone:770-265-1053
Mailing Address - Fax:
Practice Address - Street 1:7702B HAMPTON PL
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-6770
Practice Address - Country:US
Practice Address - Phone:770-265-1053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center