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General NPI Number Information
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NPI Number | 1477573293
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Entity Type | Organization
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Legal Business Name | ATLANTA PRIMARY CARE PEACHTREE, PC
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 02/23/2024
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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 | 702-251-5502
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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 | 770-487-9974
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ANDREA BENNETT
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Credential |
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Telephone | 678-487-0556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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