| 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. |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 06/23/2008 |
| Medicare PECOS PAC ID | 4486645108 |
|---|---|
| Medicare Enrollment ID | O20040521000103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649303975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Godfrey J Mark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740442318 PECOS PAC ID: 0042352726 Enrollment ID: I20100119000114 |
| Provider Name | Cedrice Nichole Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215060819 PECOS PAC ID: 0244303568 Enrollment ID: I20111116000735 |
| Provider Name | Andrea S. Videlefsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942334255 PECOS PAC ID: 5395919617 Enrollment ID: I20111123000546 |
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