| Crosslinks Family Practice, Llc | |
|
1475 Montreal Road East Tucker GA 30084-6922 | |
| (678) 292-6606 | |
| Not Available |
| Full Name | Crosslinks Family Practice, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1475 Montreal Road East, Tucker, Georgia |
| Authorized Official Name and Position | Zavier Ash (OWNER) |
| Authorized Official Contact | 6782926606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crosslinks Family Practice, Llc Po Box 390005 Snellville GA 30039-0001 Ph: (678) 292-6606 | Crosslinks Family Practice, Llc 1475 Montreal Road East Tucker GA 30084-6922 Ph: (678) 292-6606 |
| NPI Number | 1295131530 |
|---|---|
| Provider Enumeration Date | 11/14/2014 |
| Last Update Date | 11/07/2022 |
| Medicare PECOS PAC ID | 2961720222 |
|---|---|
| Medicare Enrollment ID | O20150416001415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295131530 | NPI | - | NPPES |
| 000863464F | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Latarsha Y Jones |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669528600 PECOS PAC ID: 0648210948 Enrollment ID: I20050505000891 |
| Provider Name | Latanya R Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346595378 PECOS PAC ID: 4880846278 Enrollment ID: I20121211000378 |
| Provider Name | Dzintra Leblanc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619576931 PECOS PAC ID: 2062820830 Enrollment ID: I20210415000569 |
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