Unknown Individual – Family Medicine Physician, NPI 1508890401
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
6559, Church Street, Downtown Douglasville, Douglasville, Douglas County, Georgia, 30134, United States
DOUGLASVILLE, GA 301341885
Phone: (770) 942-5111
Fax: (770) 920-8591
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30134)
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