| Eastside Medspa And Family Practice Inc. | |
|
7138 Highway 212 Suite D Covington GA 30016-8047 | |
| (770) 679-5238 | |
| Not Available |
| Full Name | Eastside Medspa And Family Practice Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 7138 Highway 212, Covington, Georgia |
| Authorized Official Name and Position | Sonia Andrea Brown (PRESIDENT) |
| Authorized Official Contact | 7726183133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastside Medspa And Family Practice Inc. 2320 Haflinger Cir Conyers GA 30012-5292 Ph: (772) 618-3133 | Eastside Medspa And Family Practice Inc. 7138 Highway 212 Suite D Covington GA 30016-8047 Ph: (770) 679-5238 |
| NPI Number | 1154330348 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1254408404 |
|---|---|
| Medicare Enrollment ID | O20080930000388 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154330348 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 057439 (Georgia) | Primary |
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