Provider Type Icon

WEATHERSTONE MEDICAL CARE LLC. NPI 1386997765


NPI Information

NPI: 1386997765
Provider Name: WEATHERSTONE MEDICAL CARE LLC.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 11D2071521

Address:
3203 S CHEROKEE LN
SUITE 220
WOODSTOCK, GA
ZIP 30188
Phone: (770) 675-6025
Get Directions

WEATHERSTONE MEDICAL CARE LLC. is a family medicine in Woodstock, 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. WEATHERSTONE MEDICAL CARE LLC. NPI is 1386997765. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3203 S CHEROKEE LN
SUITE 220
WOODSTOCK, GA
ZIP 30188-461
Phone: (770) 675-6025
Fax: (770) 675-7814

The provider's authorized official is Magdy W Rezk .
The authorized official title is Owner/ Physician and has the following contact phone number (770) 675-6025.

The CLIA number assigned to this NPI record is 11D2071521 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/22/2012 and was last updated on 10/22/2012.


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
1207Q00000XFamily Medicine053936GEORGIAYes

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
1111883MEDICARE PINGEORGIA
2H99168MEDICARE UPINGEORGIA
3186997325CMEDICAIDGEORGIA

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.