| Park Central Family Practice, Inc. | |
|
4367 New Snapfinger Woods Dr Decatur GA 30035-2920 | |
| (770) 981-2008 | |
| (770) 981-6302 |
| Full Name | Park Central Family Practice, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 4367 New Snapfinger Woods Dr, Decatur, Georgia |
| Authorized Official Name and Position | Terrie A Alexander (PRACTICE MANAGER) |
| Authorized Official Contact | 7709812008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Central Family Practice, Inc. 4367 New Snapfinger Woods Dr Decatur GA 30035-2920 Ph: (770) 981-2008 | Park Central Family Practice, Inc. 4367 New Snapfinger Woods Dr Decatur GA 30035-2920 Ph: (770) 981-2008 |
| NPI Number | 1922104306 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 05/10/2021 |
| Medicare PECOS PAC ID | 1153328752 |
|---|---|
| Medicare Enrollment ID | O20061024000328 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922104306 | NPI | - | NPPES |
| 172813090A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Georgia) | Primary |
| Provider Name | Clayton M Ramsue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659549103 PECOS PAC ID: 0749259604 Enrollment ID: I20040928000306 |
| Provider Name | Kris Manlove Simmons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649369422 PECOS PAC ID: 0345251252 Enrollment ID: I20060508000039 |
| Provider Name | Price P Omondi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477504488 PECOS PAC ID: 8325955255 Enrollment ID: I20080130000271 |
| Provider Name | Joseph G Saulsbury |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1447376058 PECOS PAC ID: 7315021730 Enrollment ID: I20080225000271 |
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