Johns Creek Gastroenterology Pc | |
1100 Northside Forsyth Dr Suite 330 Cumming GA 30041-6020 | |
(770) 889-9901 | |
(770) 889-9088 |
Full Name | Johns Creek Gastroenterology Pc |
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Speciality | Internal Medicine |
Location | 1100 Northside Forsyth Dr, Cumming, Georgia |
Authorized Official Name and Position | Clive Albert (OWNER) |
Authorized Official Contact | 7708899901 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Johns Creek Gastroenterology Pc 1100 Northside Forsyth Dr Suite 330 Cumming GA 30041-6020 Ph: (770) 889-9901 | Johns Creek Gastroenterology Pc 1100 Northside Forsyth Dr Suite 330 Cumming GA 30041-6020 Ph: (770) 889-9901 |
NPI Number | 1821272345 |
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Provider Enumeration Date | 12/19/2007 |
Last Update Date | 12/19/2007 |
Medicare PECOS PAC ID | 0941269591 |
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Medicare Enrollment ID | O20041008000160 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821272345 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | 035800 (Georgia) | Primary |
Provider Name | Clive Albert |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1821099987 PECOS PAC ID: 4385611169 Enrollment ID: I20040913000016 |
Provider Name | Kellie Cain Henderson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720459621 PECOS PAC ID: 8325324080 Enrollment ID: I20170411002279 |
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