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ELITE MEDICAL PHYSICIANS PC NPI 1679787410


NPI Information

NPI: 1679787410
Provider Name: ELITE MEDICAL PHYSICIANS PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
2892 MOUNTAIN INDUSTRIAL BLVD
TUCKER, GA
ZIP 30084
Phone: (678) 534-0452
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ELITE MEDICAL PHYSICIANS PC is a specialist in Tucker, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ELITE MEDICAL PHYSICIANS PC NPI is 1679787410. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2892 MOUNTAIN INDUSTRIAL BLVD
TUCKER, GA
ZIP 30084-014
Phone: (678) 534-0452
Fax: (678) 534-1534

The provider's authorized official is Louise A Brown .
The authorized official title is Office Manager and has the following contact phone number (678) 534-0452.

The enumeration date for this NPI number is 5/10/2007 and was last updated on 6/25/2010.


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
1174400000XSpecialist038076GEORGIAYes

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
1000596626FMEDICAIDGEORGIA
208BBQSLMEDICARE ID-TYPE UNSPECIFIEDGEORGIA
3E56780MEDICARE 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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