| Stone Mountain Family Practice, Pc | |
|
1805 Parke Plaza Cir Suite 101 Stone Mountain GA 30087-3498 | |
| (770) 469-7000 | |
| (770) 879-0436 |
| Full Name | Stone Mountain Family Practice, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1805 Parke Plaza Cir, Stone Mountain, Georgia |
| Authorized Official Name and Position | Sarah Catherine Huggins (PRESIDENT) |
| Authorized Official Contact | 7704697000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stone Mountain Family Practice, Pc 1805 Parke Plaza Cir Suite 101 Stone Mountain GA 30087-3498 Ph: (770) 469-7000 | Stone Mountain Family Practice, Pc 1805 Parke Plaza Cir Suite 101 Stone Mountain GA 30087-3498 Ph: (770) 469-7000 |
| NPI Number | 1053485037 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 02/17/2010 |
| Medicare PECOS PAC ID | 5799977468 |
|---|---|
| Medicare Enrollment ID | O20101013000639 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053485037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Martha House Crenshaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255325536 PECOS PAC ID: 4789876459 Enrollment ID: I20101013000688 |
| Provider Name | Cheri Mcclendon Schneider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427554021 PECOS PAC ID: 4688920572 Enrollment ID: I20180707000029 |
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