| Gwinnett Family Medicine And Geriatrics | |
|
706 Grayson Hwy Suite 215 Lawrenceville GA 30046-5736 | |
| (770) 316-2994 | |
| Not Available |
| Full Name | Gwinnett Family Medicine And Geriatrics |
|---|---|
| Speciality | Clinic/Center |
| Location | 706 Grayson Hwy, Lawrenceville, Georgia |
| Authorized Official Name and Position | Wezyann Gayle (CEO/OWNER) |
| Authorized Official Contact | 6466421564 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gwinnett Family Medicine And Geriatrics 706 Grayson Hwy Suite 215 Lawrenceville GA 30046-5736 Ph: (770) 316-2994 | Gwinnett Family Medicine And Geriatrics 706 Grayson Hwy Suite 215 Lawrenceville GA 30046-5736 Ph: (770) 316-2994 |
| NPI Number | 1588022438 |
|---|---|
| Provider Enumeration Date | 02/08/2016 |
| Last Update Date | 02/08/2016 |
| Medicare PECOS PAC ID | 0345536678 |
|---|---|
| Medicare Enrollment ID | O20160912002531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588022438 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 11080875 (Georgia) | Primary |
| Provider Name | Wezyann Gayle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053536177 PECOS PAC ID: 4789745712 Enrollment ID: I20081209000181 |
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