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WINGARD PRIMARY CARE LLC NPI 1326387820


NPI Information

NPI: 1326387820
Provider Name: WINGARD PRIMARY CARE, LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 11D2071830

Address:
510 SWANSON RD
TYRONE, GA
ZIP 30290
Phone: (770) 964-5230
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WINGARD PRIMARY CARE, LLC is a family medicine in Tyrone, 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. WINGARD PRIMARY CARE, LLC NPI is 1326387820. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

510 SWANSON RD
TYRONE, GA
ZIP 30290-900
Phone: (770) 964-5230
Fax: (770) 964-5260

The provider's authorized official is Ray B Bennett .
The authorized official title is Director and has the following contact phone number (770) 692-7575.

The CLIA number assigned to this NPI record is 11D2071830 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/5/2013 and was last updated on 3/28/2024.


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 MedicineGEORGIAYes
2207Q00000XFamily MedicineNo
3261QP2300XClinic/CenterPrimary Care056526GEORGIANo

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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