| Leeway Medical Group, P.c. | |
|
8311 Office Park Dr Douglasville GA 30134-6935 | |
| (770) 577-6121 | |
| (770) 577-1152 |
| Full Name | Leeway Medical Group, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 8311 Office Park Dr, Douglasville, Georgia |
| Authorized Official Name and Position | Marvin Lee Iii Md (PRESIDENT) |
| Authorized Official Contact | 7705776121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leeway Medical Group, P.c. 1665 Waterway Xing Sw Atlanta GA 30331-8060 Ph: (770) 577-6121 | Leeway Medical Group, P.c. 8311 Office Park Dr Douglasville GA 30134-6935 Ph: (770) 577-6121 |
| NPI Number | 1598857229 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 11/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598857229 | NPI | - | NPPES |
| CH8739 | Other | GA | MCRR |
| 0400158 | Other | GA | EVERCARE |
| 52255410 001 | Other | GA | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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