Unknown Individual – Internal Medicine Physician, NPI 1700878469

Unknown Individual is a healthcare provider. based in Monroe, Georgia. specializing in Internal Medicine Physician. They hold a License No. 029685 (GA). The NPI Number for Unknown Individual is 1700878469

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1700878469
Phone
(770) 267-4711
Address
PO BOX 1089
Deactivation Date
13 November 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • H A Tattersall/Pocono Medical Center Physician Associates, 1089, Peterson Road, Pocono Playhouse, Mountainhome, Monroe County, Pennsylvania, 18326, United States

    MONROE, GA 306551089

    Phone: (770) 267-4711

    Fax: (770) 267-7320

    Type: Mailing

  • Excellent Pediatrics, 333, Alcovy Street, Monroe, Walton County, Georgia, 30655, United States

    STE 3

    MONROE, GA 306552180

    Phone: (770) 267-4711

    Fax: (770) 267-7320

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30655)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1700878469 as the unique 10-digit identifier.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Monroe, Georgia.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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