Organization · NPI-2

First Lithonia Medical Center INC

Family Medicine · Lithonia, GA

NPI number1427244698
StatusActive
Last updated in NPPESApr 29, 2024

Details

NPI
1427244698
Entity type
Organization (NPI-2)
Legal business name
First Lithonia Medical Center INC
Organization subpart
No
Enumeration date
Sep 20, 2007
Certification date
Apr 29, 2024
Last updated
Apr 29, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

2505 Panola Rd
Suite A
Lithonia, GA 30058

Phone 770-323-6458 · Fax 770-323-6462

Mailing address

Po Box 965185
Marietta, GA 30066-0004

Phone 678-984-8079 · Fax 770-323-6462

Authorized official

Isioma Theresa Okobah
Ceo
7703236458

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