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General NPI Number Information
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NPI Number | 1659206407
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Entity Type | Organization
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Legal Business Name | NORTHEAST GEORGIA PHYSICIANS GROUP URGENT CARE LLC
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Dates
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Enumeration Date | 06/15/2026
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 274 BIG A RD
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City | TOCCOA
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State | GA
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Zip | 30577-6002
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Country | US
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Telephone | 706-886-3148
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 742616
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City | ATLANTA
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State | GA
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Zip | 30374-2616
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Country | US
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Telephone | 706-886-3148
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LISA HERNANDEZ
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Credential |
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Telephone | 308-765-0369
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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 |
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License Number State |
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