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General NPI Number Information
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NPI Number | 1194838706
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Entity Type | Organization
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Legal Business Name | FAMILY CARE NORTH, PC
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 1921 WHITTLESEY RD STE 200
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City | COLUMBUS
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State | GA
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Zip | 31904-9213
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Country | US
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Telephone | 706-494-1454
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Fax | 706-494-1455
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Provider Business Mailing Address
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Address Line | PO BOX 846
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City | FORTSON
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State | GA
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Zip | 31808-0846
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Country | US
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Telephone | 706-494-1454
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Fax | 706-494-1455
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Authorized Official
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Title or Position | OWNER/CFO
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Name | LINDA M CHIN
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Credential | M.D.
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Telephone | 706-494-1454
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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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