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General NPI Number Information
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NPI Number | 1629318662
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Entity Type | Organization
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Legal Business Name | STAT MEDICAL CARE INC
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Dates
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Enumeration Date | 02/28/2013
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | 9690 VENTANA WAY
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City | JOHNS CREEK
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State | GA
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Zip | 30022-6394
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Country | US
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Telephone | 770-623-6773
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Fax | 770-232-9882
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Provider Business Mailing Address
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Address Line | 9690 VENTANA WAY
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City | JOHNS CREEK
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State | GA
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Zip | 30022-6394
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Country | US
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Telephone | 770-623-6773
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Fax | 770-232-9882
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. JAMES JOSEPH DUGAL
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Credential | M.D.
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Telephone | 770-623-6773
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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 | GA025341
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License Number State | GA
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