=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245186915
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WON DIRECT PRIMARY CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2026
-----------------------------------------------------
Last Update Date | 03/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1123 CLAIRMONT RD
-----------------------------------------------------
City | DECATUR
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30030-1228
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-359-9910
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1605 CHURCH ST STE 610-110
-----------------------------------------------------
City | DECATUR
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30033-6065
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-358-9910
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ CEO
-----------------------------------------------------
Name | DR. ASHLEIGH IGBOKWE-HAMILTON
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 678-359-9910
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------