| |
165 S Broad St Butler GA 31006-5526 | |
(478) 862-2220 | |
Not Available |
Full Name | |
---|---|
Speciality | Family Medicine - Geriatric Medicine |
Location | 165 S Broad St, Butler, Georgia |
Authorized Official Name and Position | Charles Kemp (VICE PRESIDENT OF OPERATIONS) |
Authorized Official Contact | 4044010225 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
4080 Mcginnis Ferry Rd Suite 804 Alpharetta GA 30005-3948 Ph: (404) 401-0225 | 165 S Broad St Butler GA 31006-5526 Ph: (478) 862-2220 |
NPI Number | 1730430968 |
---|---|
Provider Enumeration Date | 09/27/2012 |
Last Update Date | 09/27/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730430968 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
Decker Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 18 S Broad St, Butler, GA 31006 Phone: 478-837-7121 Fax: 478-837-7020 | |