MEDICARE: PHYSICIANS EXPRESS CARE AT MORNINGSIDE 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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1831731165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS EXPRESS CARE AT MORNINGSIDE LLC

Provider Business Mailing Address
First Line	:	1780 PEACHTREE PKWY STE 302
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30041-6834
Country	:	US
Telephone Number	:	470-695-7339
Fax Number	:

Provider Business Practice Location Address
First Line	:	1799 BRIARCLIFF RD NE STE Q1
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30306-2142
Country	:	US
Telephone Number	:	770-772-1830
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANGER
Name	:	SHERRY DUKES
Credential	:
Telephone Number	:	770-772-1830

Provider Enumeration Date	:	10/08/2019
Last Update Date	:	01/20/2020

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