My Medical Ally, Llc | |
2751 Buford Hwy Ne Atlanta GA 30324-3207 | |
(404) 477-1797 | |
Not Available |
Full Name | My Medical Ally, Llc |
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Speciality | Family Medicine |
Location | 2751 Buford Hwy Ne, Atlanta, Georgia |
Authorized Official Name and Position | Alesia Reynolds (OWNER) |
Authorized Official Contact | 4044771797 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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My Medical Ally, Llc Po Box 550747 Atlanta GA 30355-3247 Ph: () - | My Medical Ally, Llc 2751 Buford Hwy Ne Atlanta GA 30324-3207 Ph: (404) 477-1797 |
NPI Number | 1457998742 |
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Provider Enumeration Date | 12/05/2019 |
Last Update Date | 12/05/2019 |
Medicare PECOS PAC ID | 9537596119 |
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Medicare Enrollment ID | O20200219003055 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457998742 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Tiffany Johnson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104334846 PECOS PAC ID: 2769819416 Enrollment ID: I20200219001457 |
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