Healthcare Provider Details

I. General information

NPI: 1710371885
Provider Name (Legal Business Name): GWINNETT URGENT AND FAMILY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 06/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4775 JIMMY CARTER BLVD SUITE 201
NORCROSS GA
30093-3760
US

IV. Provider business mailing address

4775 JIMMY CARTER BLVD SUITE 201
NORCROSS GA
30093-3760
US

V. Phone/Fax

Practice location:
  • Phone: 470-275-4911
  • Fax: 470-275-4918
Mailing address:
  • Phone: 470-275-4911
  • Fax: 470-275-4918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TONG M HUYNH
Title or Position: DIRECTOR
Credential: MD
Phone: 470-275-4911