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EXECUTIVE MEDICAL ASSOCIATES NPI 1518297266


NPI Information

NPI: 1518297266
Provider Name: EXECUTIVE MEDICAL ASSOCIATES
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 11D1054094

Address:
4500 HUGH HOWELL RD
BUILDING 270, SUITE B
TUCKER, GA
ZIP 30084
Phone: (770) 723-0817
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EXECUTIVE MEDICAL ASSOCIATES is an internal medicine in Tucker, 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. EXECUTIVE MEDICAL ASSOCIATES NPI is 1518297266. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4500 HUGH HOWELL RD
BUILDING 270, SUITE B
TUCKER, GA
ZIP 30084-723
Phone: (770) 723-0817
Fax: (770) 723-1691

The provider's authorized official is Lee Wilkes .
The authorized official title is Medical Director and has the following contact phone number (770) 723-0817.

The CLIA number assigned to this NPI record is 11D1054094 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/31/2009 and was last updated on 12/31/2009.


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 MedicineYes

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

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