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FAMILY PRACTICE OF HABERSHAM PC NPI 1093717357


NPI Information

NPI: 1093717357
Provider Name: FAMILY PRACTICE OF HABERSHAM PC

Doing Business As: HABERSHAM PRIMARY CARE

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 11D0676816

Address:
590 HISTORIC HWY 441 N
DEMOREST, GA
ZIP 30535
Phone: (706) 754-5511
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FAMILY PRACTICE OF HABERSHAM PC is an internal medicine in Demorest, GA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. FAMILY PRACTICE OF HABERSHAM PC NPI is 1093717357. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Habersham Primary Care.

The provider's business location address is:

590 HISTORIC HWY 441 N
DEMOREST, GA
ZIP 30535
Phone: (706) 754-5511
Fax: (706) 754-5577

The provider's authorized official is Beverly Carol Carter .
The authorized official title is Practice Manager and has the following contact phone number (706) 754-5511.

The CLIA number assigned to this NPI record is 11D0676816 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/1/2005 and was last updated on 1/4/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine032741GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CI7226MEDICARE ID-TYPE UNSPECIFIEDGEORGIARAILROAD MEDICARE NUMBER
2GRP3078MEDICARE ID-TYPE UNSPECIFIEDGEORGIAMEDICARE GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.