Family Practice Of Atlanta Llc | |
1428 Scott Blvd Decatur GA 30030-1424 | |
(404) 296-8100 | |
(404) 294-8467 |
Full Name | Family Practice Of Atlanta Llc |
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Speciality | Clinic/center - Primary Care |
Location | 1428 Scott Blvd, Decatur, Georgia |
Authorized Official Name and Position | Sondi Saddia Moore-waters (MEDICAL DIRECTOR) |
Authorized Official Contact | 4042968100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Family Practice Of Atlanta Llc 1428 Scott Blvd Decatur GA 30030-1424 Ph: (404) 296-8100 | Family Practice Of Atlanta Llc 1428 Scott Blvd Decatur GA 30030-1424 Ph: (404) 296-8100 |
NPI Number | 1790966976 |
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Provider Enumeration Date | 11/16/2007 |
Last Update Date | 03/04/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790966976 | NPI | - | NPPES |
GRP6402 | Other | GA | MEDICARE GROUP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 031294 (Georgia) | Primary |
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