| Jydes Family Clinic Llc | |
|
4720 Peachtree Industrial Blvd Suite 4101 Norcross GA 30071-5735 | |
| (770) 686-3232 | |
| (770) 686-3233 |
| Full Name | Jydes Family Clinic Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4720 Peachtree Industrial Blvd, Norcross, Georgia |
| Authorized Official Name and Position | Haolat Abiola Babalakin (CEO/OWNER) |
| Authorized Official Contact | 6784667342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jydes Family Clinic Llc 5805 State Bridge Rd Suite G-106 Johns Creek GA 30097-8220 Ph: (770) 903-4665 | Jydes Family Clinic Llc 4720 Peachtree Industrial Blvd Suite 4101 Norcross GA 30071-5735 Ph: (770) 686-3232 |
| NPI Number | 1275840944 |
|---|---|
| Provider Enumeration Date | 09/01/2010 |
| Last Update Date | 12/15/2014 |
| Medicare PECOS PAC ID | 9739368838 |
|---|---|
| Medicare Enrollment ID | O20110121000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275840944 | NPI | - | NPPES |
| 202G263383 | Other | GA | MEDICARE PTAN |
| Provider Name | Haolat A Babalakin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245337708 PECOS PAC ID: 8325093206 Enrollment ID: I20090629000304 |
| Provider Name | Deirdre C Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225431240 PECOS PAC ID: 8224355607 Enrollment ID: I20150324000428 |
| Provider Name | Tricia A Strickland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447613351 PECOS PAC ID: 0749574432 Enrollment ID: I20160803000803 |
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