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SMYRNA FAMILY MEDICINE LLC NPI 1598168650


NPI Information

NPI: 1598168650
Provider Name: SMYRNA FAMILY MEDICINE, LLC

Doing Business As: PREMIER PRIMARY CARE MEDICINE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 11D2231906

Address:
3903 S COBB DR SE STE 200
SMYRNA, GA
ZIP 30080
Phone: (770) 292-0043
Get Directions

SMYRNA FAMILY MEDICINE, LLC is a family medicine in Smyrna, 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. SMYRNA FAMILY MEDICINE, LLC NPI is 1598168650. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Premier Primary Care Medicine.

The provider's business location address is:

3903 S COBB DR SE STE 200
SMYRNA, GA
ZIP 30080-301
Phone: (770) 292-0043
Fax: (888) 556-8420

The provider's authorized official is David N Kim .
The authorized official title is Ceo and has the following contact phone number (770) 292-0043.

The CLIA number assigned to this NPI record is 11D2231906 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/3/2014 and was last updated on 4/23/2024.


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 MedicineGA050306GEORGIAYes
2363A00000XPhysician Assistant000489GEORGIANo

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
100922864AMEDICAIDGEORGIA

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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