| Liveon Medical Center | |
|
80 Vinings Dr Mcdonough GA 30253-5994 | |
| (770) 302-6780 | |
| (678) 782-3776 |
| Full Name | Liveon Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 80 Vinings Dr, Mcdonough, Georgia |
| Authorized Official Name and Position | Ernie Fletcher (CEO/PHYSICIAN) |
| Authorized Official Contact | 7703026780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liveon Medical Center 80 Vinings Dr Mcdonough GA 30253-5994 Ph: (770) 302-6780 | Liveon Medical Center 80 Vinings Dr Mcdonough GA 30253-5994 Ph: (770) 302-6780 |
| NPI Number | 1265770515 |
|---|---|
| Provider Enumeration Date | 01/22/2013 |
| Last Update Date | 03/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265770515 | NPI | - | NPPES |
| 003201616A | Medicaid | GA | |
| 202G708497 | Other | GA | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 64538 (Georgia) | Primary |
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