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GENESIS FAMILY MEDICINE & AESTHETICS LLC NPI 1417406513


NPI Information

NPI: 1417406513
Provider Name: GENESIS FAMILY MEDICINE & AESTHETICS, LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
7316 SPOUT SPRINGS RD
SUITE 201
FLOWERY BRANCH, GA
ZIP 30542
Phone: (678) 262-8242
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GENESIS FAMILY MEDICINE & AESTHETICS, LLC is a family medicine in Flowery Branch, 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. GENESIS FAMILY MEDICINE & AESTHETICS, LLC NPI is 1417406513. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7316 SPOUT SPRINGS RD
SUITE 201
FLOWERY BRANCH, GA
ZIP 30542-665
Phone: (678) 262-8242

The provider's authorized official is Maribel Chavez .
The authorized official title is Ceo/cfo and has the following contact phone number (678) 262-8242.

The enumeration date for this NPI number is 9/29/2016 and was last updated on 9/29/2016.


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 Medicine33410GEORGIAYes

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
1000647006AMEDICAIDGEORGIA
2D42053MEDICARE UPINGEORGIA

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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