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General NPI Number Information
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NPI Number | 1386078517
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Entity Type | Organization
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Legal Business Name | NEWNAN FAMILY MEDICINE ASSOCIATES
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Dates
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Enumeration Date | 08/23/2013
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Last Update Date | 08/23/2013
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Provider Practice Location Address
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Address Line | 51 HOSPITAL RD
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City | NEWNAN
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State | GA
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Zip | 30263-1209
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Country | US
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Telephone | 770-251-5540
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Fax | 770-251-5502
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Provider Business Mailing Address
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Address Line | 51 HOSPITAL RD
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City | NEWNAN
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State | GA
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Zip | 30263-1209
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Country | US
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Telephone | 770-251-5540
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Fax | 770-251-5502
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ELAINE A MCKOY
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Credential |
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Telephone | 770-251-5540
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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 | 024357
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License Number State | GA
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