YOUTHFUL ESSENCE MD LLC NPI 1467811265

NPI Information

  • NPI: 1467811265
  • Provider Name: YOUTHFUL ESSENCE MD, LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 1230 JOHNSON FERRY PL
    SUITE A10
    MARIETTA, GA
    ZIP 30068
  • Phone: (678) 903-0533

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NPI Details

YOUTHFUL ESSENCE MD, LLC is a family medicine in Marietta, 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. YOUTHFUL ESSENCE MD, LLC NPI is 1467811265. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1230 JOHNSON FERRY PL
SUITE A10
MARIETTA, GA
ZIP 30068-048
Phone: (678) 903-0533
Fax: (678) 903-0548

The provider's authorized official is Fannie Clark .
The authorized official title is Revenue Recovery Consultant and has the following contact phone number (678) 531-9692.

The enumeration date for this NPI number is 2/22/2016 and was last updated on 2/22/2016.

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 Medicine17323874GEORGIAYes

What is NPI?

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This page was last updated on: 3/30/2025

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