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General NPI Number Information
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NPI Number | 1144337023
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Entity Type | Organization
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Legal Business Name | CUMMING FAMILY MEDICINE INC
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 765 LANIER 400 PKWY
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City | CUMMING
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State | GA
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Zip | 30040-2539
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Country | US
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Telephone | 770-205-1294
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Fax | 770-205-1783
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Provider Business Mailing Address
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Address Line | 765 LANIER 400 PKWY
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City | CUMMING
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State | GA
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Zip | 30040-2539
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Country | US
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Telephone | 770-205-1294
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Fax | 770-205-1783
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEEVANA KRISHNA
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Credential | M.D.
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Telephone | 770-205-1274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 032759
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License Number State | GA
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