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General NPI Number Information
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NPI Number | 1316716251
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Entity Type | Organization
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Legal Business Name | NORTHEAST GEORGIA PHYSICIANS GROUP-URGENT CARE, LLC
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 4445 S LEE ST STE 105
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City | BUFORD
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State | GA
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Zip | 30518-8806
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Country | US
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Telephone | 770-848-9240
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1060
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City | OAKWOOD
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State | GA
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Zip | 30566-0018
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Country | US
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Telephone | 770-219-8351
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KAREN L REYER
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Credential |
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Telephone | 770-219-8051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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