| North Fulton Primary Care - Wylie Bridge, Llc | |
|
14205 Highway 92 Suite 105 Woodstock GA 30188-7138 | |
| (678) 293-7854 | |
| (770) 740-8503 |
| Full Name | North Fulton Primary Care - Wylie Bridge, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 14205 Highway 92, Woodstock, Georgia |
| Authorized Official Name and Position | Wesley O. James (REGIONAL CFO, TENET) |
| Authorized Official Contact | 4042655009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Fulton Primary Care - Wylie Bridge, Llc Po Box 742595 Atlanta GA 30374-2595 Ph: (678) 293-7854 | North Fulton Primary Care - Wylie Bridge, Llc 14205 Highway 92 Suite 105 Woodstock GA 30188-7138 Ph: (678) 293-7854 |
| NPI Number | 1326472283 |
|---|---|
| Provider Enumeration Date | 08/28/2013 |
| Last Update Date | 06/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326472283 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | (* (Not Available)) | Secondary |
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