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NPI Code Detail

MEDICARE: CARTERSVILLE PHYSICIAN PRACTICE NETWORK, INC

MEDICARE: CARTERSVILLE PHYSICIAN PRACTICE NETWORK, INC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1760472104
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARTERSVILLE PHYSICIAN PRACTICE NETWORK, INC
Provider Business Mailing Address
First Line : 960 JOE FRANK HARRIS PKWY SE
Second Line :
City : CARTERSVILLE
State : GA
Zip : 30120-2129
Country : US
Telephone Number : 770-382-1530
Fax Number : 770-606-2127
Provider Business Practice Location Address
First Line : 960 JOE FRANK HARRIS PKWY SE
Second Line :
City : CARTERSVILLE
State : GA
Zip : 30120-2129
Country : US
Telephone Number : 770-382-1530
Fax Number : 770-606-2127
Authorized Official
Title or Position : DIRECTOR
Name : MR. PATRICK BIRMINGHAM
Credential :
Telephone Number : 615-373-7625
Provider Enumeration Date : 10/26/2005
Last Update Date : 08/22/2020

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Directions to “CARTERSVILLE PHYSICIAN PRACTICE NETWORK, INC ” Practice Location

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