Organization · NPI-2

Dominique Crain Locums LLC

Clinic/Center, Urgent Care · Sandy Springs, GA

NPI number1790566271
StatusActive
Last updated in NPPESJan 8, 2024

Details

NPI
1790566271
Entity type
Organization (NPI-2)
Legal business name
Dominique Crain Locums LLC
Organization subpart
No
Enumeration date
Oct 10, 2023
Certification date
Jan 8, 2024
Last updated
Jan 8, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QU0200X Clinic/Center, Urgent Care––Yes
282N00000X General Acute Care Hospital––
207Q00000X Family Medicine––
261QP2300X Clinic/Center, Primary Care––

Other names

  • Dc Locums Family Medicine LLC (Doing Business As)

Practice location

6660 Roswell Rd
Sandy Springs, GA 30328-3167

Phone 470-491-4328

Mailing address

Po Box 851982
Mobile, AL 36685-1982

Phone 470-491-4328

Authorized official

Dominique Juanita Crain
Founder/Ceo/Physician
4704914328

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