| Ellijay Urgent Care & Family Practice | |
|
97 Hefner St Ste 202 East Ellijay GA 30540-8268 | |
| (706) 635-5177 | |
| (706) 635-2274 |
| Full Name | Ellijay Urgent Care & Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 97 Hefner St Ste 202, East Ellijay, Georgia |
| Authorized Official Name and Position | Ellijay Urgent Care Family Practice. (OWNER) |
| Authorized Official Contact | 7066355177 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellijay Urgent Care & Family Practice 97 Hefner St Ste 202 East Ellijay GA 30540-8268 Ph: (706) 635-2273 | Ellijay Urgent Care & Family Practice 97 Hefner St Ste 202 East Ellijay GA 30540-8268 Ph: (706) 635-5177 |
| NPI Number | 1700237633 |
|---|---|
| Provider Enumeration Date | 06/22/2016 |
| Last Update Date | 10/01/2018 |
| Medicare PECOS PAC ID | 8426343880 |
|---|---|
| Medicare Enrollment ID | O20160824000856 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700237633 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 062579 (Georgia) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Thomas A Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669495669 PECOS PAC ID: 8325033640 Enrollment ID: I20090930000083 |
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