Healthcare Provider Details

I. General information

NPI: 1528336674
Provider Name (Legal Business Name): PHYSICIANS EXPRESS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2011
Last Update Date: 05/09/2024
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11758 JONES BRIDGE RD
ALPHARETTA GA
30005-5065
US

IV. Provider business mailing address

1780 PEACHTREE PKWY STE 302
CUMMING GA
30041-6834
US

V. Phone/Fax

Practice location:
  • Phone: 770-772-1830
  • Fax: 770-772-7238
Mailing address:
  • Phone: 770-772-1830
  • Fax: 470-239-7296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number51875
License Number StateGA

VIII. Authorized Official

Name: SHERRY DARLENE DUKES
Title or Position: BILLING MANAGER/PRIVACY OFFICER
Credential: RN
Phone: 470-695-7339