MEDICARE: DR. BETTY ELIZABETH STRONG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	39485	GA

General Provider Information

NPI Number	:	1093728404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETTY ELIZABETH STRONG MD

Provider Business Mailing Address
First Line	:	1203 CLEVELAND AVE
Second Line	:	SUITE 1-A
City	:	EAST POINT
State	:	GA
Zip	:	30344-3417
Country	:	US
Telephone Number	:	404-835-2891
Fax Number	:	404-835-2899

Provider Business Practice Location Address
First Line	:	1203 CLEVELAND AVE
Second Line	:	SUITE 1-A
City	:	EAST POINT
State	:	GA
Zip	:	30344-3417
Country	:	US
Telephone Number	:	404-835-2891
Fax Number	:	404-835-2899

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	05/31/2016

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