Healthcare Provider Details

I. General information

NPI: 1467493189
Provider Name (Legal Business Name): FAMILY CARE OF CARTERSVILLE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 01/07/2022
Certification Date: 01/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 FOX CHASE
CARTERSVILLE GA
30120-2491
US

IV. Provider business mailing address

PO BOX 2016
CARTERSVILLE GA
30120-1684
US

V. Phone/Fax

Practice location:
  • Phone: 770-382-0185
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBIN RODGERS
Title or Position: MD/OWNER
Credential:
Phone: 770-382-0185