Clarkston Primary & Urgent Care, LLC
Family Medicine in Clarkston, GA. Organization (NPI-2).
NPI number1043781420
StatusActive
Last updated in NPPESDec 11, 2018
Details
- NPI
- 1043781420
- Entity type
- Organization (NPI-2)
- Legal business name
- Clarkston Primary & Urgent Care, LLC
- Organization subpart
- No
- Enumeration date
- Dec 11, 2018
- Last updated
- Dec 11, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Clarkston Primary & Urgent Care LLC (Former Legal Business Name)
- Clarkston Primary & Urgent Care LLC (Doing Business As)
Practice location
4600 E Ponce De Leon Ave Ste AClarkston, GA 30021-1839
Phone 770-703-5408 · Fax 877-779-5837
Mailing address
4600 E Ponce De Leon Ave Ste AClarkston, GA 30021-1839
Phone 770-703-5408 · Fax 877-779-5837
Authorized official
Etsubdenke Areaya
Authorized Official
6787632247
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All 8 Family Medicine Physician providers in Clarkston · All 147 providers in Clarkston
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