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General NPI Number Information
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NPI Number | 1306040225
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Entity Type | Organization
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Legal Business Name | COMPLETE CARE OF GEORGIA, P.C.
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 5040 SNAPFINGER WOODS DR SUITE 201
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City | DECATUR
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State | GA
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Zip | 30035-4020
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Country | US
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Telephone | 770-808-8500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3760
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City | DECATUR
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State | GA
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Zip | 30031-3760
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Country | US
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Telephone | 770-808-8500
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CRYSTAL BARNWELL
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Credential | M.D.
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Telephone | 770-808-8500
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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 | 042997
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License Number State | GA
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