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General NPI Number Information
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NPI Number | 1629222419
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Entity Type | Organization
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Legal Business Name | NEW HOPE URGENT CARE LLC
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 02/02/2009
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Provider Practice Location Address
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Address Line | 49 HOSIERY MILL RD STE 124
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City | DALLAS
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State | GA
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Zip | 30157-1687
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Country | US
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Telephone | 770-443-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 49 HOSIERY MILL RD STE 124
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City | DALLAS
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State | GA
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Zip | 30157-1687
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Country | US
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Telephone | 770-443-6111
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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. JAN RENEE MAYFIELD
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Credential | MD, FACEP
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Telephone | 770-655-2020
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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 | 051355
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License Number State | GA
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