| Smokerise Family Medical Assoc | |
|
1505 Lilburn Stone Mountain Rd Ste 100 Stone Mountain GA 30087-1857 | |
| (770) 469-1711 | |
| (770) 469-1837 |
| Full Name | Smokerise Family Medical Assoc |
|---|---|
| Speciality | Family Medicine |
| Location | 1505 Lilburn Stone Mountain Rd, Stone Mountain, Georgia |
| Authorized Official Name and Position | Michael Lesley Baron (FAMILY PHYSICIAN/PRESIDENT) |
| Authorized Official Contact | 7704691711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smokerise Family Medical Assoc 1505 Lilburn Stone Mountain Rd Ste 100 Stone Mountain GA 30087-1857 Ph: (770) 469-1711 | Smokerise Family Medical Assoc 1505 Lilburn Stone Mountain Rd Ste 100 Stone Mountain GA 30087-1857 Ph: (770) 469-1711 |
| NPI Number | 1326340829 |
|---|---|
| Provider Enumeration Date | 12/03/2010 |
| Last Update Date | 12/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326340829 | NPI | - | NPPES |
| 00474779A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0033273 (Georgia) | Primary |
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