| Sugarloaf Primary Care | |
|
4835 Sugarloaf Pkwy Suite 300 Lawrenceville GA 30044-6912 | |
| (407) 375-5940 | |
| (407) 375-5952 |
| Full Name | Sugarloaf Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 4835 Sugarloaf Pkwy, Lawrenceville, Georgia |
| Authorized Official Name and Position | Ronnie Hendrix (PARTNER) |
| Authorized Official Contact | 4073755940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sugarloaf Primary Care 4835 Sugarloaf Pkwy Suite 300 Lawrenceville GA 30044-6912 Ph: (407) 375-5940 | Sugarloaf Primary Care 4835 Sugarloaf Pkwy Suite 300 Lawrenceville GA 30044-6912 Ph: (407) 375-5940 |
| NPI Number | 1043629942 |
|---|---|
| Provider Enumeration Date | 08/05/2014 |
| Last Update Date | 08/05/2014 |
| Medicare PECOS PAC ID | 8224337894 |
|---|---|
| Medicare Enrollment ID | O20160503001632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043629942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 061255 (Georgia) | Primary |
| Provider Name | Steven a Durocher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962402461 PECOS PAC ID: 6204892284 Enrollment ID: I20050526000495 |
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