FAYETTE CARE CLINIC NPI 1003552282

NPI Information

  • NPI: 1003552282
  • Provider Name: FAYETTE CARE CLINIC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 11D2110908
  • Address: 1260 HIGHWAY 54 W STE 101
    FAYETTEVILLE, GA
    ZIP 30214
  • Phone: (770) 719-4620

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NPI Details

FAYETTE CARE CLINIC is a family medicine in Fayetteville, GA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FAYETTE CARE CLINIC NPI is 1003552282. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1260 HIGHWAY 54 W STE 101
FAYETTEVILLE, GA
ZIP 30214-525
Phone: (770) 719-4620
Fax: (770) 719-4622

The provider's authorized official is Susan Williams .
The authorized official title is Practice Coordinator and has the following contact phone number (770) 719-4620.

The CLIA number assigned to this NPI record is 11D2110908 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/10/2022 and was last updated on 5/10/2022.

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
1207Q00000XFamily 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: 3/30/2025

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