Eagle's Landing Family Practice

NPI 1073829073 - Family Medicine - 207Q00000X

NPI Details
NPI 1073829073
Enumeration Date 08/27/2010
Last Updated 08/27/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name WENDY WENDY
Position CREDENTIALING COORDINATOR
Phone (678) 490-0341
Fax (678) 490-0349
Practice Location
2200 HIGHWAY 155 N
MCDONOUGH GA, 30252-4806, US
Phone (678) 490-0341
Fax (678) 490-0349
Business Location
2200 HIGHWAY 155 N
MCDONOUGH GA, 30252-4806, US
Phone (678) 490-0341
Fax (678) 490-0349
Toxanomy
Taxonomy Code 207Q00000X
License State Georgia
License Number 61547
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According to our database, Eagle's Landing Family Practice NPI is 1073829073, taxonomy code is 207Q00000X and license number is 61547, license state is located at Georgia. Eagle's Landing Family Practice physically located at 2200 Highway 155 N, Mcdonough GA, 30252-4806. NPI Number 1033115704 has the healthcare provider type.

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1073829073 NPI number is provided on an as is basis without warranty of any kind. 1073829073 is maintained by the National Plan & Provider Enumeration System. The contents of Eagle's Landing Family Practice are for informational purposes only.