MEDICARE: PRIMARY CARE PARTNERS, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1306939657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY CARE PARTNERS, PC

Provider Business Mailing Address
First Line	:	1431 WHITE CIR
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-5801
Country	:	US
Telephone Number	:	770-424-2929
Fax Number	:	770-424-5557

Provider Business Practice Location Address
First Line	:	1431 WHITE CIR
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-5801
Country	:	US
Telephone Number	:	770-424-2929
Fax Number	:	770-424-5557

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MS. JAN F CHADWICK
Credential	:
Telephone Number	:	770-424-2929

Provider Enumeration Date	:	10/01/2006
Last Update Date	:	08/22/2020

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