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General NPI Number Information
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NPI Number | 1114483831
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Entity Type | Organization
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Legal Business Name | CARING PARTNERS MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 10 GLENLAKE PKWY STE 130
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City | ATLANTA
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State | GA
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Zip | 30328-3495
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Country | US
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Telephone | 404-580-0270
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Fax | 678-601-1365
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Provider Business Mailing Address
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Address Line | 4436 MADISON WOODS DR
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City | MARIETTA
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State | GA
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Zip | 30064-1595
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Country | US
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Telephone | 678-230-7095
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Fax | 678-601-1365
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ANDREW M LACY
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Credential |
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Telephone | 678-230-7095
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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 |
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License Number State |
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