| Decker Family Practice | |
|
18 S Broad St Butler GA 31006-5520 | |
| (478) 837-7121 | |
| (478) 837-7020 |
| Full Name | Decker Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 18 S Broad St, Butler, Georgia |
| Authorized Official Name and Position | Laura Decker (MEMBER) |
| Authorized Official Contact | 4782130223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Decker Family Practice 118 S Broad St Butler GA 31006-5525 Ph: (478) 213-0223 | Decker Family Practice 18 S Broad St Butler GA 31006-5520 Ph: (478) 837-7121 |
| NPI Number | 1689320640 |
|---|---|
| Provider Enumeration Date | 02/28/2022 |
| Last Update Date | 03/09/2022 |
| Medicare PECOS PAC ID | 7517352776 |
|---|---|
| Medicare Enrollment ID | O20220325000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689320640 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kimberly A Crook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518268838 PECOS PAC ID: 7315134640 Enrollment ID: I20101213000102 |
| Provider Name | Laura S Decker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326441080 PECOS PAC ID: 6204150766 Enrollment ID: I20150112000765 |
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