| Hga Villa Rica, Llc | |
|
129 Bankhead Hwy Carrollton GA 30117-3425 | |
| (770) 838-8440 | |
| Not Available |
| Full Name | Hga Villa Rica, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 129 Bankhead Hwy, Carrollton, Georgia |
| Authorized Official Name and Position | Vaughn S Clagette (PARTNER) |
| Authorized Official Contact | 7708388440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hga Villa Rica, Llc Po Box 6084 Douglasville GA 30154-0019 Ph: () - | Hga Villa Rica, Llc 129 Bankhead Hwy Carrollton GA 30117-3425 Ph: (770) 838-8440 |
| NPI Number | 1033644067 |
|---|---|
| Provider Enumeration Date | 04/27/2017 |
| Last Update Date | 04/27/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033644067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 40639 (Georgia) | Primary |
| 208M00000X | Hospitalist | 40639 (Georgia) | Secondary |
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