MEDICARE: FLOWERS MEDICAL GROUP, LLC

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	261Q00000X	Clinic/Center	20217959386	GA

General Provider Information

NPI Number	:	1295088557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLOWERS MEDICAL GROUP, LLC

Provider Business Mailing Address
First Line	:	6425 POWERS FERRY RD NW
Second Line	:	SUITE 175
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30339-2908
Country	:	US
Telephone Number	:	678-303-4420
Fax Number	:

Provider Business Practice Location Address
First Line	:	6425 POWERS FERRY RD NW
Second Line	:	SUITE 175
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30339-2908
Country	:	US
Telephone Number	:	678-303-4420
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LYNN K FLOWERS
Credential	:	MD
Telephone Number	:	678-303-4420

Provider Enumeration Date	:	10/23/2012
Last Update Date	:	10/23/2012

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