| Landmark Medical Of Tennessee Pc | |
|
1230 Peachtree St Ne Fl 19 Atlanta GA 30309-3574 | |
| (657) 400-5180 | |
| Not Available |
| Full Name | Landmark Medical Of Tennessee Pc |
|---|---|
| Speciality | General Practice |
| Location | 1230 Peachtree St Ne Fl 19, Atlanta, Georgia |
| Authorized Official Name and Position | Michael Huy Le (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 6574005180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Landmark Medical Of Tennessee Pc 7755 Center Ave Ste 630 Huntington Beach CA 92647-9152 Ph: () - | Landmark Medical Of Tennessee Pc 1230 Peachtree St Ne Fl 19 Atlanta GA 30309-3574 Ph: (657) 400-5180 |
| NPI Number | 1841914090 |
|---|---|
| Provider Enumeration Date | 09/30/2022 |
| Last Update Date | 09/30/2022 |
| Medicare PECOS PAC ID | 8527453851 |
|---|---|
| Medicare Enrollment ID | O20230104000952 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841914090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Joy A Safo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174139281 PECOS PAC ID: 8022428598 Enrollment ID: I20211101003091 |
| Provider Name | David Moen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942312301 PECOS PAC ID: 9830149624 Enrollment ID: I20230104001730 |
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