Healthcare Provider Details

I. General information

NPI: 1518185040
Provider Name (Legal Business Name): CHANDRA BRITT ARMSTRONG MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2007
Last Update Date: 07/01/2022
Certification Date: 07/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1862 CANDLER RD
DECATUR GA
30032-4163
US

IV. Provider business mailing address

1862 CANDLER RD
DECATUR GA
30032-4163
US

V. Phone/Fax

Practice location:
  • Phone: 404-289-4556
  • Fax: 678-720-0440
Mailing address:
  • Phone: 404-289-4556
  • Fax: 404-478-2779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number155972
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SAMUEL D ARMSTRONG
Title or Position: ADMINISTRATOR
Credential: MBA
Phone: 678-521-7557