EJESE HEALTHCARE PC NPI 1093800823

NPI Information

  • NPI: 1093800823
  • Provider Name: EJESE HEALTHCARE, PC
  • Classification: Family Medicine - 207QA0505X
  • Specialization: Adult Medicine
  • Entity Type: Organization
  • :
  • Address: 125 COMMONS WAY STE 203
    VILLA RICA, GA
    ZIP 30180
  • Phone: (770) 456-6118

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NPI Details

EJESE HEALTHCARE, PC is an adult medicine family medicine in Villa Rica, GA. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. EJESE HEALTHCARE, PC NPI is 1093800823. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

125 COMMONS WAY STE 203
VILLA RICA, GA
ZIP 30180-041
Phone: (770) 456-6118
Fax: (770) 456-6227

The provider's authorized official is James K Irungu .
The authorized official title is Billing Contact and has the following contact phone number (770) 456-6118.

The enumeration date for this NPI number is 10/4/2006 and was last updated on 9/11/2025.

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 Medicine055684GEORGIANo
2207QA0505XFamily MedicineAdult 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: 11/21/2025

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