Tucker Medical Center P.c. | |
4445 Cowan Rd Tucker GA 30084-4829 | |
(770) 938-0275 | |
(770) 939-6225 |
Full Name | Tucker Medical Center P.c. |
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Speciality | Family Medicine |
Location | 4445 Cowan Rd, Tucker, Georgia |
Authorized Official Name and Position | John L Oprysko (PRESIDENT) |
Authorized Official Contact | 7709380275 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tucker Medical Center P.c. 4445 Cowan Rd Tucker GA 30084-4829 Ph: (770) 938-0275 | Tucker Medical Center P.c. 4445 Cowan Rd Tucker GA 30084-4829 Ph: (770) 938-0275 |
NPI Number | 1235403353 |
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Provider Enumeration Date | 03/07/2012 |
Last Update Date | 03/07/2012 |
Medicare PECOS PAC ID | 4981863099 |
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Medicare Enrollment ID | O20120309000082 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235403353 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 34211 (Georgia) | Primary |
Provider Name | John Oprysko |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1700849874 PECOS PAC ID: 5890954903 Enrollment ID: I20120309000099 |
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