| Physicians' Immediate Med | |
|
1834 Clairmont Rd Decatur GA 30033-3405 | |
| (404) 634-4443 | |
| (404) 634-4414 |
| Full Name | Physicians' Immediate Med |
|---|---|
| Speciality | Clinic/Center |
| Location | 1834 Clairmont Rd, Decatur, Georgia |
| Authorized Official Name and Position | Nicole Jordan (OFFICE MANAGER) |
| Authorized Official Contact | 7708888777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physicians' Immediate Med 1834 Clairmont Rd Decatur GA 30033-3405 Ph: (404) 634-4443 | Physicians' Immediate Med 1834 Clairmont Rd Decatur GA 30033-3405 Ph: (404) 634-4443 |
| NPI Number | 1235573841 |
|---|---|
| Provider Enumeration Date | 04/25/2013 |
| Last Update Date | 08/29/2013 |
| Medicare PECOS PAC ID | 3072741818 |
|---|---|
| Medicare Enrollment ID | O20140124000587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235573841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Michael D Mudrey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376574863 PECOS PAC ID: 0042292120 Enrollment ID: I20040602001450 |
| Provider Name | Lonny E Horowitz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1568475515 PECOS PAC ID: 2163433830 Enrollment ID: I20060509000524 |
| Provider Name | Erin D London |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851359038 PECOS PAC ID: 7719079243 Enrollment ID: I20070913000295 |
| Provider Name | Joseph G Saulsbury |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1447376058 PECOS PAC ID: 7315021730 Enrollment ID: I20080225000271 |
| Provider Name | Elizabeth R Gordon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548445356 PECOS PAC ID: 5991856783 Enrollment ID: I20090708000424 |
| Provider Name | James Yost |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295910073 PECOS PAC ID: 0042402471 Enrollment ID: I20101004001439 |
| Provider Name | Tyra Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477727543 PECOS PAC ID: 4688850175 Enrollment ID: I20110518000247 |
| Provider Name | Fidias E De Leon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1871756155 PECOS PAC ID: 6507909835 Enrollment ID: I20121024000231 |
| Provider Name | Mary Kathleen Humphries |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578862173 PECOS PAC ID: 8224258991 Enrollment ID: I20140930002574 |
| Provider Name | Kinzi Shewmake |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568473809 PECOS PAC ID: 3577633791 Enrollment ID: I20150716000494 |
| Provider Name | Nihinlolawa Oreoluwa Ijamakinwa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174843833 PECOS PAC ID: 8426284571 Enrollment ID: I20151012001271 |
| Provider Name | Adebowale Akintayo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902148752 PECOS PAC ID: 8527377043 Enrollment ID: I20151023002099 |
| Provider Name | Foroogh Narmani-mohammadi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447659347 PECOS PAC ID: 3678878758 Enrollment ID: I20160226002154 |
| Provider Name | Megha Amin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710346325 PECOS PAC ID: 1456658012 Enrollment ID: I20160324001600 |
| Provider Name | Yusef Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699904243 PECOS PAC ID: 5597911487 Enrollment ID: I20160613000609 |
| Provider Name | Sydney R Deal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790198919 PECOS PAC ID: 0143501858 Enrollment ID: I20170111000688 |
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