United Physician Group Llc | |
13 Corporate Blvd Ne Ste 100 Brookhaven GA 30329-1905 | |
(678) 505-9657 | |
Not Available |
Full Name | United Physician Group Llc |
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Speciality | Family Medicine |
Location | 13 Corporate Blvd Ne Ste 100, Brookhaven, Georgia |
Authorized Official Name and Position | Christian Fletcher (CEO) |
Authorized Official Contact | 8335230906 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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United Physician Group Llc 13 Corporate Blvd Ne Ste 100 Brookhaven GA 30329-1905 Ph: (678) 505-9657 | United Physician Group Llc 13 Corporate Blvd Ne Ste 100 Brookhaven GA 30329-1905 Ph: (678) 505-9657 |
NPI Number | 1922579192 |
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Provider Enumeration Date | 12/16/2018 |
Last Update Date | 09/15/2020 |
Medicare PECOS PAC ID | 7113267956 |
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Medicare Enrollment ID | O20190314000835 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922579192 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Chandra B Armstrong |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1376625053 PECOS PAC ID: 4183517618 Enrollment ID: I20040206000542 |
Provider Name | Daryl Sherrod |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851354740 PECOS PAC ID: 5799760609 Enrollment ID: I20040623000747 |
Provider Name | Lashonda A Carter |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548424864 PECOS PAC ID: 6204902018 Enrollment ID: I20080902000337 |
Provider Name | Natasha R Williams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902072945 PECOS PAC ID: 7416018593 Enrollment ID: I20081208000437 |
Provider Name | Jelunder Ann Woodard Clark |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508881368 PECOS PAC ID: 6709976012 Enrollment ID: I20111114000393 |
Provider Name | Mcfrances George |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669926663 PECOS PAC ID: 0244510659 Enrollment ID: I20161130002268 |
Provider Name | Latoya Katrese Buford |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043738909 PECOS PAC ID: 2769739606 Enrollment ID: I20180723003473 |
Provider Name | Kali L Gordon |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1508106600 PECOS PAC ID: 7012265275 Enrollment ID: I20180803000622 |
Provider Name | Vera Mahou |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598278558 PECOS PAC ID: 9830442557 Enrollment ID: I20181026001252 |
Provider Name | Magdalene Oziwo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245688613 PECOS PAC ID: 3779919931 Enrollment ID: I20200206000865 |
Provider Name | Jessica H Manu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710379730 PECOS PAC ID: 8022308246 Enrollment ID: I20200213001717 |
Provider Name | Erlande Richard-azinord |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164901039 PECOS PAC ID: 5597150896 Enrollment ID: I20220324000105 |
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