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General NPI Number Information
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NPI Number | 1427791631
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Entity Type | Organization
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Legal Business Name | PRIMO HEALTH PARTNERS
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Dates
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Enumeration Date | 04/15/2022
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Last Update Date | 04/15/2022
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Provider Practice Location Address
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Address Line | 3635 RIVERS CALL BLVD
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City | ATLANTA
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State | GA
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Zip | 30339-8502
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Country | US
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Telephone | 404-293-0039
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Fax |
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Provider Business Mailing Address
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Address Line | 3635 RIVERS CALL BLVD
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City | ATLANTA
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State | GA
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Zip | 30339-8502
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Country | US
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Telephone | 404-293-0039
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CHAIRMAN
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Name | WILLIAM COOPER
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Credential | MD, MBA, FACC
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Telephone | 404-293-0039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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