| Dunwoody Village Clinic, Pc | |
|
5471 Chamblee Dunwoody Rd Dunwoody GA 30338 | |
| (770) 481-0889 | |
| (770) 481-0986 |
| Full Name | Dunwoody Village Clinic, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5471 Chamblee Dunwoody Rd, Dunwoody, Georgia |
| Authorized Official Name and Position | James J Kinahan (OWNER, DUNWOODY VILLAGE CLINIC) |
| Authorized Official Contact | 7704810889 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dunwoody Village Clinic, Pc 5471 Chamblee Dunwoody Rd Dunwoody GA 30338-4114 Ph: (770) 481-0889 | Dunwoody Village Clinic, Pc 5471 Chamblee Dunwoody Rd Dunwoody GA 30338 Ph: (770) 481-0889 |
| NPI Number | 1457494502 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 03/24/2010 |
| Medicare PECOS PAC ID | 8022061639 |
|---|---|
| Medicare Enrollment ID | O20050223000644 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457494502 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | James J Kinahan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326006321 PECOS PAC ID: 3274599659 Enrollment ID: I20041207001020 |
| Provider Name | Etienne J Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679709539 PECOS PAC ID: 1557527876 Enrollment ID: I20120731000471 |
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