| Canton Family Care | |
|
200 Medical Ln Canton GA 30114-2421 | |
| (770) 479-1494 | |
| (770) 720-3492 |
| Full Name | Canton Family Care |
|---|---|
| Speciality | Family Medicine |
| Location | 200 Medical Ln, Canton, Georgia |
| Authorized Official Name and Position | Dorise A House (INSURANCE MANAGER) |
| Authorized Official Contact | 7704791494 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canton Family Care 200 Medical Ln Canton GA 30114-2421 Ph: (770) 479-1494 | Canton Family Care 200 Medical Ln Canton GA 30114-2421 Ph: (770) 479-1494 |
| NPI Number | 1669526604 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 12/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669526604 | NPI | - | NPPES |
| 00291189A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 015374 (Georgia) | Primary |
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