MEDICARE: AUBURN PRIMARY CARE PC

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	044330	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205056587
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUBURN PRIMARY CARE PC

Provider Business Mailing Address
First Line	:	12 7TH STREET
Second Line	:
City	:	AUBURN
State	:	GA
Zip	:	30011
Country	:	US
Telephone Number	:	770-822-5555
Fax Number	:	770-822-6117

Provider Business Practice Location Address
First Line	:	12 7TH STREET
Second Line	:
City	:	AUBURN
State	:	GA
Zip	:	30011
Country	:	US
Telephone Number	:	770-822-5555
Fax Number	:	770-822-6117

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RICHARD MARK SCHLOSSBERG
Credential	:	M.D.
Telephone Number	:	770-822-5555

Provider Enumeration Date	:	04/27/2007
Last Update Date	:	08/22/2020

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Directions to “AUBURN PRIMARY CARE PC ” Practice Location

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