INTOWN FAMILY PRACTICE & SPORTS MEDICINE PC NPI 1235446394

NPI Information

NPI: 1235446394
Provider Name: INTOWN FAMILY PRACTICE & SPORTS MEDICINE PC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
285 BOULEVARD AVE NE
SUITE 640
ATLANTA, GA
ZIP 30312
Phone: (404) 577-7800
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INTOWN FAMILY PRACTICE & SPORTS MEDICINE PC is a primary care clinic center in Atlanta, GA. INTOWN FAMILY PRACTICE & SPORTS MEDICINE PC NPI is 1235446394. The provider is registered as an organization entity type.

The provider's business location address is:

285 BOULEVARD AVE NE
SUITE 640
ATLANTA, GA
ZIP 30312-212
Phone: (404) 577-7800
Fax: (404) 577-7810

The provider's authorized official is Lawrence Leo Golusinski .
The authorized official title is Owner and has the following contact phone number (404) 577-7800.

The enumeration date for this NPI number is 9/9/2010 and was last updated on 9/9/2010.

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
1	261QP2300X	Clinic/Center	Primary Care	20330	NORTH CAROLINA	No
2	261QP2300X	Clinic/Center	Primary Care	038777	GEORGIA	Yes

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
1	=========	OTHER	GEORGIA	HUMANA
2	=========	OTHER	GEORGIA	TRICARE
3	08BBVZB	MEDICARE PIN	GEORGIA
4	F26943	MEDICARE UPIN	GEORGIA
5	4546534	OTHER	GEORGIA	AETNA
6	160928	OTHER	GEORGIA	COVENTRY HEALTHCARE
7	0191191	OTHER	GEORGIA	UNITED HEALTHCARE
8	52476640002	OTHER	GEORGIA	BCBS OF GA
9	1013698006	OTHER	GEORGIA	CIGNA HEALTHCARE
10	776894	OTHER	GEORGIA	FIRST HEALTH

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

NPI Synchronization or Removal

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