| Lifetime Medical Center, Pc | |
|
14244 Highway 515 N Suite 100 Ellijay GA 30536 | |
| (706) 698-5433 | |
| Not Available |
| Full Name | Lifetime Medical Center, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 14244 Highway 515 N, Ellijay, Georgia |
| Authorized Official Name and Position | Lee Kent (ADMINISTRATOR) |
| Authorized Official Contact | 7066985433 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetime Medical Center, Pc 14244 Highway 515 N Suite 100 Ellijay GA 30536 Ph: (706) 698-5433 | Lifetime Medical Center, Pc 14244 Highway 515 N Suite 100 Ellijay GA 30536 Ph: (706) 698-5433 |
| NPI Number | 1982933107 |
|---|---|
| Provider Enumeration Date | 12/17/2009 |
| Last Update Date | 08/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982933107 | NPI | - | NPPES |
| 202 G701 589 | Other | GA | MEDICARE GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 051241 (Georgia) | Primary |
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