| Mountain East Family Medicine | |
|
4120 Five Forks Trickum Rd Sw Suite 105 Lilburn GA 30047-3130 | |
| (770) 921-6900 | |
| Not Available |
| Full Name | Mountain East Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 4120 Five Forks Trickum Rd Sw, Lilburn, Georgia |
| Authorized Official Name and Position | Chuck Locke (VP) |
| Authorized Official Contact | 8006613365 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain East Family Medicine 4120 Five Forks Trickum Rd Sw Suite 105 Lilburn GA 30047-3130 Ph: (770) 921-6900 | Mountain East Family Medicine 4120 Five Forks Trickum Rd Sw Suite 105 Lilburn GA 30047-3130 Ph: (770) 921-6900 |
| NPI Number | 1891737425 |
|---|---|
| Provider Enumeration Date | 06/11/2006 |
| Last Update Date | 08/29/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891737425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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