Dekalb Family Practice, P.c. | |
5462 Memorial Dr Suite 202 Stone Mountain GA 30083-3239 | |
(404) 292-5676 | |
(404) 299-8657 |
Full Name | Dekalb Family Practice, P.c. |
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Speciality | Family Medicine |
Location | 5462 Memorial Dr, Stone Mountain, Georgia |
Authorized Official Name and Position | Edward Alvin Corkran (PRESIDENT) |
Authorized Official Contact | 4042925676 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Dekalb Family Practice, P.c. 5462 Memorial Dr Suite 202 Stone Mountain GA 30083-3239 Ph: (404) 292-5676 | Dekalb Family Practice, P.c. 5462 Memorial Dr Suite 202 Stone Mountain GA 30083-3239 Ph: (404) 292-5676 |
NPI Number | 1255584744 |
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Provider Enumeration Date | 10/28/2008 |
Last Update Date | 10/28/2008 |
Identifier | Type | State | Issuer |
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1255584744 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 030034 (Georgia) | Primary |
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