| New League Family Practice | |
|
428 Waterbury Dr Lawrenceville GA 30046-3323 | |
| (470) 209-8177 | |
| (678) 310-1550 |
| Full Name | New League Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 428 Waterbury Dr, Lawrenceville, Georgia |
| Authorized Official Name and Position | Nathalie Celestin-watson (CREDENTIALING LIAISON/ OWNER) |
| Authorized Official Contact | 4702098177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New League Family Practice Po Box 466607 Lawrenceville GA 30042-6607 Ph: (470) 209-8177 | New League Family Practice 428 Waterbury Dr Lawrenceville GA 30046-3323 Ph: (470) 209-8177 |
| NPI Number | 1902290570 |
|---|---|
| Provider Enumeration Date | 03/23/2015 |
| Last Update Date | 01/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902290570 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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