| Myfamilydoc LLC | |
|
101 Adams Dr Demorest GA 30535-4565 | |
| (706) 778-3912 | |
| (706) 776-6259 |
| Full Name | Myfamilydoc LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 101 Adams Dr, Demorest, Georgia |
| Authorized Official Name and Position | Ravin Batuk Talati (DIRECTOR/PHYSICIAN) |
| Authorized Official Contact | 7067783912 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Myfamilydoc LLC 101 Adams Dr Demorest GA 30535-4565 Ph: (706) 778-3912 | Myfamilydoc LLC 101 Adams Dr Demorest GA 30535-4565 Ph: (706) 778-3912 |
| NPI Number | 1346580982 |
|---|---|
| Provider Enumeration Date | 02/19/2013 |
| Last Update Date | 08/27/2023 |
| Certification Date | 08/27/2023 |
| Medicare PECOS PAC ID | 6608021969 |
|---|---|
| Medicare Enrollment ID | O20130313000140 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346580982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 67172 (Georgia) | Primary |
| Provider Name | Ravin Talati |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1598920357 PECOS PAC ID: 0143498212 Enrollment ID: I20120501000740 |
| Provider Name | Paramvir Singh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801102652 PECOS PAC ID: 4789802745 Enrollment ID: I20140904001671 |
| Provider Name | Stephanie S Wellborn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063828408 PECOS PAC ID: 4587885488 Enrollment ID: I20141017001238 |
| Provider Name | Courtney L Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801454749 PECOS PAC ID: 7517356660 Enrollment ID: I20211111001979 |
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