Urban Family Practice Associates, P.c. | |
2520 Windy Hill Rd Se Suite 301 Marietta GA 30067-8664 | |
(770) 952-1032 | |
(770) 952-8579 |
Full Name | Urban Family Practice Associates, P.c. |
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Speciality | Family Medicine |
Location | 2520 Windy Hill Rd Se, Marietta, Georgia |
Authorized Official Name and Position | Eileen J. Fields (PRACTICE ADMINISTRATOR) |
Authorized Official Contact | 7709521032 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Urban Family Practice Associates, P.c. 2520 Windy Hill Rd Se Suite 301 Marietta GA 30067-8664 Ph: (770) 952-1032 | Urban Family Practice Associates, P.c. 2520 Windy Hill Rd Se Suite 301 Marietta GA 30067-8664 Ph: (770) 952-1032 |
NPI Number | 1649303975 |
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Provider Enumeration Date | 03/14/2007 |
Last Update Date | 06/23/2008 |
Medicare PECOS PAC ID | 4486645108 |
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Medicare Enrollment ID | O20040521000103 |
Identifier | Type | State | Issuer |
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1649303975 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Godfrey J Mark |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1740442318 PECOS PAC ID: 0042352726 Enrollment ID: I20100119000114 |
Provider Name | Cedrice Nichole Davis |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1215060819 PECOS PAC ID: 0244303568 Enrollment ID: I20111116000735 |
Provider Name | Andrea S. Videlefsky |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1942334255 PECOS PAC ID: 5395919617 Enrollment ID: I20111123000546 |
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