| United Physician Group Llc | |
|
13 Corporate Blvd Ne Ste 100 Brookhaven GA 30329-1905 | |
| (678) 505-9657 | |
| Not Available |
| Full Name | United Physician Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 13 Corporate Blvd Ne Ste 100, Brookhaven, Georgia |
| Authorized Official Name and Position | Christian Fletcher (CEO) |
| Authorized Official Contact | 8335230906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| United Physician Group Llc 13 Corporate Blvd Ne Ste 100 Brookhaven GA 30329-1905 Ph: (678) 505-9657 | United Physician Group Llc 13 Corporate Blvd Ne Ste 100 Brookhaven GA 30329-1905 Ph: (678) 505-9657 |
| NPI Number | 1922579192 |
|---|---|
| Provider Enumeration Date | 12/16/2018 |
| Last Update Date | 09/15/2020 |
| Medicare PECOS PAC ID | 7113267956 |
|---|---|
| Medicare Enrollment ID | O20190314000835 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922579192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Daryl Sherrod |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851354740 PECOS PAC ID: 5799760609 Enrollment ID: I20040623000747 |
| Provider Name | Lashonda A Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548424864 PECOS PAC ID: 6204902018 Enrollment ID: I20080902000337 |
| Provider Name | Natasha R Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902072945 PECOS PAC ID: 7416018593 Enrollment ID: I20081208000437 |
| Provider Name | Jelunder Ann Woodard Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508881368 PECOS PAC ID: 6709976012 Enrollment ID: I20111114000393 |
| Provider Name | Mcfrances George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669926663 PECOS PAC ID: 0244510659 Enrollment ID: I20161130002268 |
| Provider Name | Latoya Katrese Buford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043738909 PECOS PAC ID: 2769739606 Enrollment ID: I20180723003473 |
| Provider Name | Kali L Gordon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1508106600 PECOS PAC ID: 7012265275 Enrollment ID: I20180803000622 |
| Provider Name | Vera Mahou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598278558 PECOS PAC ID: 9830442557 Enrollment ID: I20181026001252 |
| Provider Name | Magdalene Oziwo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245688613 PECOS PAC ID: 3779919931 Enrollment ID: I20200206000865 |
| Provider Name | Jessica Henrietta Oppong Asumadu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710379730 PECOS PAC ID: 8022308246 Enrollment ID: I20200213001717 |
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