Peachtree Immediate Care Fp, LLC
Family Medicine in Oakwood, GA. Organization (NPI-2).
NPI number1982190039
StatusActive
Last updated in NPPESJul 2, 2018
Details
- NPI
- 1982190039
- Entity type
- Organization (NPI-2)
- Legal business name
- Peachtree Immediate Care Fp, LLC
- Organization subpart
- No
- Enumeration date
- Jul 2, 2018
- Last updated
- Jul 2, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | INV-3-18-12009 | GA | Yes |
Other names
- Peachtree Immediate Care (Doing Business As)
Practice location
3885 Mundy Mill Rd Ste 114Oakwood, GA 30566-3432
Phone 678-971-1892 · Fax 678-971-1895
Mailing address
1275 Highway 54 W Ste 201Fayetteville, GA 30214-4538
Phone 678-688-9685 · Fax 770-626-3791
Authorized official
Andrea Malik-Roe
Cfo
6785046392
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