Healthcare Provider Details

I. General information

NPI: 1629025143
Provider Name (Legal Business Name): APOGEE MEDICAL GROUP GEORGIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2006
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 DIXIE ST
CARROLLTON GA
30117-3818
US

IV. Provider business mailing address

PO BOX 25016
DALLAS TX
75225-1016
US

V. Phone/Fax

Practice location:
  • Phone: 770-836-9667
  • Fax: 770-838-8931
Mailing address:
  • Phone: 972-269-1897
  • Fax: 469-249-1170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN J HARWELL
Title or Position: CFO
Credential:
Phone: 602-778-3600