Guthery Family Practice Clinic | |
809 W Bankhead Hwy Ste D Villa Rica GA 30180-1520 | |
(678) 615-9519 | |
Not Available |
Full Name | Guthery Family Practice Clinic |
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Speciality | Family Medicine |
Location | 809 W Bankhead Hwy Ste D, Villa Rica, Georgia |
Authorized Official Name and Position | Henry Charles Guthery (PHYSICIAN) |
Authorized Official Contact | 6786159519 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Guthery Family Practice Clinic 809 W Bankhead Hwy Ste D Villa Rica GA 30180-1520 Ph: (678) 615-9519 | Guthery Family Practice Clinic 809 W Bankhead Hwy Ste D Villa Rica GA 30180-1520 Ph: (678) 615-9519 |
NPI Number | 1902400559 |
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Provider Enumeration Date | 11/24/2020 |
Last Update Date | 12/07/2021 |
Medicare PECOS PAC ID | 8022421460 |
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Medicare Enrollment ID | O20210104001873 |
Identifier | Type | State | Issuer |
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1902400559 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Henry Charles Guthery |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1255787651 PECOS PAC ID: 9830479492 Enrollment ID: I20190909000872 |
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