Healthcare Provider Details

I. General information

NPI: 1033030879
Provider Name (Legal Business Name): GEORGIA PRIMARY CARE PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 GA 155 N SUITE 207
MCDONOUGH GA
30252
US

IV. Provider business mailing address

60 EXCHANGE ST STE B5
RICHMOND HILL GA
31324-7646
US

V. Phone/Fax

Practice location:
  • Phone: 678-271-6997
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BETH KOHN
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 727-776-9642