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LONGEVITY MEDICAL CENTER PC NPI 1124596069


NPI Information

NPI: 1124596069
Provider Name: LONGEVITY MEDICAL CENTER, PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
4646 N SHALLOWFORD RD STE 300
ATLANTA, GA
ZIP 30338
Phone: (678) 736-6383
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LONGEVITY MEDICAL CENTER, PC is a family medicine in Atlanta, 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. LONGEVITY MEDICAL CENTER, PC NPI is 1124596069. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4646 N SHALLOWFORD RD STE 300
ATLANTA, GA
ZIP 30338-308
Phone: (678) 736-6383
Fax: (678) 280-6761

The provider's authorized official is Saira Sultan .
The authorized official title is Doo and has the following contact phone number (770) 676-6000.

The enumeration date for this NPI number is 11/8/2018 and was last updated on 11/8/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
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: 4/28/2024

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