| Ivy Falls Family Medicine | |
|
10475 Medlock Bridge Rd Suite 815 Duluth GA 30097-2002 | |
| (678) 990-4828 | |
| (678) 990-4824 |
| Full Name | Ivy Falls Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 10475 Medlock Bridge Rd, Duluth, Georgia |
| Authorized Official Name and Position | Andrea L Sells (OFFICE MANAGER) |
| Authorized Official Contact | 6789904828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivy Falls Family Medicine 10475 Medlock Bridge Rd Suite 815 Duluth GA 30097-2002 Ph: (678) 990-4828 | Ivy Falls Family Medicine 10475 Medlock Bridge Rd Suite 815 Duluth GA 30097-2002 Ph: (678) 990-4828 |
| NPI Number | 1922118595 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 06/19/2012 |
| Medicare PECOS PAC ID | 1456355601 |
|---|---|
| Medicare Enrollment ID | O20060831000288 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922118595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | BL0600486 (Georgia) | Primary |
| Provider Name | Patrick J Voswinkel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548207442 PECOS PAC ID: 8628072873 Enrollment ID: I20060831000440 |
| Provider Name | Karen Duvall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235499724 PECOS PAC ID: 5799931473 Enrollment ID: I20120813000309 |
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