Hillandale Primary Care

NPI 1417133893 - Family Medicine - 207Q00000X

NPI Details
NPI 1417133893
Enumeration Date 01/15/2008
Last Updated 01/15/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name CLARICE M CLARICE
Position OWNER
Phone (770) 322-9660
Fax (770) 322-1981
Practice Location
5900 HILLANDALE DR
SUITE 215
LITHONIA GA, 30058-3802, US
Phone (770) 322-9660
Fax (770) 322-1981
Business Location
5900 HILLANDALE DR
SUITE 215
LITHONIA GA, 30058-3802, US
Phone (770) 322-9660
Fax (770) 322-1981
Toxanomy
Taxonomy Code 207Q00000X
License State Georgia
License Number 039730
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According to our database, Hillandale Primary Care NPI is 1417133893, taxonomy code is 207Q00000X and license number is 039730, license state is located at Georgia. Hillandale Primary Care physically located at 5900 Hillandale Dr, Lithonia GA, 30058-3802. NPI Number 1033115704 has the healthcare provider type.

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1417133893 NPI number is provided on an as is basis without warranty of any kind. 1417133893 is maintained by the National Plan & Provider Enumeration System. The contents of Hillandale Primary Care are for informational purposes only.