| Kigga, Llc | |
|
310 Gold Creek Trl Ste 100 Woodstock GA 30188-5436 | |
| (770) 637-6004 | |
| Not Available |
| Full Name | Kigga, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 310 Gold Creek Trl Ste 100, Woodstock, Georgia |
| Authorized Official Name and Position | Allison Kern (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 7722817682 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kigga, Llc 310 Gold Creek Trl Ste 100 Woodstock GA 30188-5436 Ph: () - | Kigga, Llc 310 Gold Creek Trl Ste 100 Woodstock GA 30188-5436 Ph: (770) 637-6004 |
| NPI Number | 1033723671 |
|---|---|
| Provider Enumeration Date | 09/01/2020 |
| Last Update Date | 09/01/2020 |
| Medicare PECOS PAC ID | 6103246681 |
|---|---|
| Medicare Enrollment ID | O20201022000668 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033723671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Raymond E Easley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255323655 PECOS PAC ID: 7517144504 Enrollment ID: I20110531000110 |
| Provider Name | Jeremias Rafael Duarte |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1780189514 PECOS PAC ID: 8628478229 Enrollment ID: I20210619000072 |
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