| Premier Primary Care Medicine | |
|
3903 S Cobb Dr Se Ste 200 Smyrna GA 30080-6301 | |
| (770) 292-0043 | |
| (888) 556-8420 |
| Full Name | Premier Primary Care Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 3903 S Cobb Dr Se Ste 200, Smyrna, Georgia |
| Authorized Official Name and Position | David N Kim (CEO) |
| Authorized Official Contact | 7702920043 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Primary Care Medicine 4480 South Cobb Dr Bldg H, Ste 399 Smyrna GA 30080 Ph: (770) 292-0043 | Premier Primary Care Medicine 3903 S Cobb Dr Se Ste 200 Smyrna GA 30080-6301 Ph: (770) 292-0043 |
| NPI Number | 1598168650 |
|---|---|
| Provider Enumeration Date | 10/03/2014 |
| Last Update Date | 05/01/2024 |
| Medicare PECOS PAC ID | 2769704774 |
|---|---|
| Medicare Enrollment ID | O20141202001675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598168650 | NPI | - | NPPES |
| 00922864A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | GA050306 (Georgia) | Primary |
| 363A00000X | Physician Assistant | 000489 (Georgia) | Secondary |
| Provider Name | David N Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568433498 PECOS PAC ID: 6204025869 Enrollment ID: I20110112000938 |
| Provider Name | Shalin Kirit Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649808189 PECOS PAC ID: 3072938521 Enrollment ID: I20230308001804 |
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