| Livi Family Medicine Llc | |
|
115 Grayson Industrial Pkwy Ste 12 Grayson GA 30017-4139 | |
| (706) 305-6911 | |
| (770) 302-0482 |
| Full Name | Livi Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 115 Grayson Industrial Pkwy Ste 12, Grayson, Georgia |
| Authorized Official Name and Position | Uzoma Ndukwe (PHYSICIAN/CO-OWNER) |
| Authorized Official Contact | 7066120424 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Livi Family Medicine Llc Po Box 250 Grayson GA 30017-0005 Ph: (770) 305-6911 | Livi Family Medicine Llc 115 Grayson Industrial Pkwy Ste 12 Grayson GA 30017-4139 Ph: (706) 305-6911 |
| NPI Number | 1407464084 |
|---|---|
| Provider Enumeration Date | 07/20/2020 |
| Last Update Date | 05/28/2021 |
| Medicare PECOS PAC ID | 5991115883 |
|---|---|
| Medicare Enrollment ID | O20201104001302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407464084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ndubuisi A Ndukwe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215268040 PECOS PAC ID: 4880718378 Enrollment ID: I20100907000325 |
| Provider Name | Uzoma E Ndukwe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427302215 PECOS PAC ID: 1557503398 Enrollment ID: I20130807000935 |
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