Healthcare Provider Details
I. General information
NPI: 1578590527
Provider Name (Legal Business Name): FAMILY HEALTH ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/26/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
63 W CANDLER ST
WINDER GA
30680-2558
US
IV. Provider business mailing address
63 W CANDLER ST
WINDER GA
30680-2558
US
V. Phone/Fax
- Phone: 770-867-4541
- Fax: 770-867-2583
- Phone: 770-867-4541
- Fax: 770-867-2583
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | GA |
VIII. Authorized Official
Name: DR.
GAREY
H
HUFF
JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 770-867-4541