Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wellstar Medical Group, LLC

Organization Surgery Physician · NPI 1164715132

Wellstar Medical Group, LLC provides Surgery Physician services in Douglasville, Georgia. Licensed in Georgia. Registered with an NPI since 2011.

Licensed in
GA
In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4904 Timber Ridge Dr Ste 104
Douglasville, GA 30135-1828 Not confirmed with CMS for 12 years — call before visiting
Phone: (770) 942-4822
Fax: (770) 942-5311
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X (GA)

Record details

NPI number1164715132
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationWellstar Medical Group, LLC
Authorized official Nicole Ashe — Executive Director Of Finance · (470) 644-0095
Other names Wellstar Douglas Surgical Associates
NPI enumeratedMay 24, 2011
Last updated in NPPESNovember 19, 2013
Mailing address4904 Timber Ridge Dr, Suite 104, Douglasville, GA 30135-1828

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