| North Chattahoochee Family Physicians, Llc | |
|
11459 Johns Creek Pkwy Suite 250 Johns Creek GA 30097-3515 | |
| (770) 497-1555 | |
| (770) 497-9998 |
| Full Name | North Chattahoochee Family Physicians, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 11459 Johns Creek Pkwy, Johns Creek, Georgia |
| Authorized Official Name and Position | Debra Collazo (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7704971555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Chattahoochee Family Physicians, Llc 11459 Johns Creek Pkwy Suite 250 Johns Creek GA 30097-3515 Ph: (770) 497-1555 | North Chattahoochee Family Physicians, Llc 11459 Johns Creek Pkwy Suite 250 Johns Creek GA 30097-3515 Ph: (770) 497-1555 |
| NPI Number | 1114041928 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 04/18/2022 |
| Medicare PECOS PAC ID | 6406954296 |
|---|---|
| Medicare Enrollment ID | O20070601000103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114041928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Georgia) | Primary |
| Provider Name | Paul D Ellis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740297811 PECOS PAC ID: 1850496878 Enrollment ID: I20070601000164 |
| Provider Name | Lisa Lillich Culpepper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316951999 PECOS PAC ID: 7012017577 Enrollment ID: I20110714000462 |
| Provider Name | Henry Lawrence Gardiner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346275658 PECOS PAC ID: 1658471115 Enrollment ID: I20110715000386 |
| Provider Name | Christian-jevon Bramwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336632918 PECOS PAC ID: 9830440684 Enrollment ID: I20220516001905 |
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