| Genesys Family Practice, Inc. | |
|
120 Handley Rd Suite 410 Tyrone GA 30290 | |
| (770) 964-5810 | |
| (678) 364-1216 |
| Full Name | Genesys Family Practice, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 120 Handley Rd, Tyrone, Georgia |
| Authorized Official Name and Position | Ivy Yvonne Smith (OWNER) |
| Authorized Official Contact | 7709645810 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesys Family Practice, Inc. 120 Handley Rd Suite 410 Tyrone GA 30290 Ph: (770) 964-5810 | Genesys Family Practice, Inc. 120 Handley Rd Suite 410 Tyrone GA 30290 Ph: (770) 964-5810 |
| NPI Number | 1407973936 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 08/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407973936 | NPI | - | NPPES |
| 407530212B | Medicaid | GA | |
| 088BRJB | Other | GA | MEDICARE ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 053075 (Georgia) | Primary |
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