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General NPI Number Information
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NPI Number | 1013961846
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE CLINICS OF GEORGIA
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 1240 JESSE JEWELL PKWY SE SUITE 370
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City | GAINESVILLE
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State | GA
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Zip | 30501-3862
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Country | US
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Telephone | 770-536-1004
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Fax | 770-536-0905
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Provider Business Mailing Address
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Address Line | 1240 JESSE JEWELL PKWY SE SUITE 370
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City | GAINESVILLE
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State | GA
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Zip | 30501-3861
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Country | US
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Telephone | 770-536-1004
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DAVID LEON HOCKER
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Credential | M.D., M.R.O.
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Telephone | 770-536-1004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 041138
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License Number State | GA
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