| Correctmed Locust Grove, Llc | |
|
4861 Bill Gardner Pkwy Suite 100 Locust Grove GA 30248-3644 | |
| (770) 626-5740 | |
| (770) 626-5750 |
| Full Name | Correctmed Locust Grove, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4861 Bill Gardner Pkwy, Locust Grove, Georgia |
| Authorized Official Name and Position | Linda Faulkner (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 7706265740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Correctmed Locust Grove, Llc Po Box 538502 Atlanta GA 30353-8502 Ph: (770) 626-5740 | Correctmed Locust Grove, Llc 4861 Bill Gardner Pkwy Suite 100 Locust Grove GA 30248-3644 Ph: (770) 626-5740 |
| NPI Number | 1245554682 |
|---|---|
| Provider Enumeration Date | 03/14/2010 |
| Last Update Date | 09/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245554682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 053123 (Georgia) | Primary |
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