| Clara M Picayo Md Professional Corporation | |
|
5570 Bells Ferry Rd Acworth GA 30102-2526 | |
| (770) 926-2757 | |
| (770) 926-2758 |
| Full Name | Clara M Picayo Md Professional Corporation |
|---|---|
| Speciality | General Practice |
| Location | 5570 Bells Ferry Rd, Acworth, Georgia |
| Authorized Official Name and Position | Clara M Picayo (PHYSICIAN / PRESIDENT) |
| Authorized Official Contact | 7709262757 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clara M Picayo Md Professional Corporation 5570 Bells Ferry Rd Acworth GA 30102-2526 Ph: (770) 926-2757 | Clara M Picayo Md Professional Corporation 5570 Bells Ferry Rd Acworth GA 30102-2526 Ph: (770) 926-2757 |
| NPI Number | 1104000660 |
|---|---|
| Provider Enumeration Date | 12/19/2007 |
| Last Update Date | 01/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104000660 | NPI | - | NPPES |
| 608406833B | Medicaid | GA | |
| 01149193 | Other | GA | AMERIGROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 058381 (Georgia) | Primary |
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