| Premier South Medical Group Pc | |
|
770 Greison Trl Suite F Newnan GA 30263-6408 | |
| (770) 251-4120 | |
| (770) 251-4575 |
| Full Name | Premier South Medical Group Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 770 Greison Trl, Newnan, Georgia |
| Authorized Official Name and Position | Reanna Ramkhelawan (CONTRACTING SPECIALIST) |
| Authorized Official Contact | 7862812398 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier South Medical Group Pc 8750 Nw 36th St Suite 300 Doral FL 33178-2425 Ph: (786) 641-5348 | Premier South Medical Group Pc 770 Greison Trl Suite F Newnan GA 30263-6408 Ph: (770) 251-4120 |
| NPI Number | 1669916573 |
|---|---|
| Provider Enumeration Date | 12/12/2016 |
| Last Update Date | 12/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669916573 | NPI | - | NPPES |
| 003182726A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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