GRAYSON PRIMARY CARE LLC NPI 1417903451

NPI Information

  • NPI: 1417903451
  • Provider Name: GRAYSON PRIMARY CARE LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 2594 LOGANVILLE HWY
    SUITE 101
    GRAYSON, GA
    ZIP 30017
  • Phone: (678) 225-4999

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NPI Details

GRAYSON PRIMARY CARE LLC is a family medicine in Grayson, 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. GRAYSON PRIMARY CARE LLC NPI is 1417903451. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2594 LOGANVILLE HWY
SUITE 101
GRAYSON, GA
ZIP 30017-617
Phone: (678) 225-4999
Fax: (678) 225-5546

The provider's authorized official is Mark Pickett .
The authorized official title is Vp and has the following contact phone number (678) 762-5037.

The enumeration date for this NPI number is 5/25/2006 and was last updated on 4/20/2008.

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 MedicineYes

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
1=========OTHERGEORGIATRICARE
2GRP7753MEDICARE PINGEORGIA

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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