ELITE FAMILY PRACTICE NPI 1710236880

NPI Information

  • NPI: 1710236880
  • Provider Name: ELITE FAMILY PRACTICE
  • Classification: Preferred Provider Organization - 305R00000X
  • Entity Type: Organization
  • CLIA Number: 11D0998471
  • Address: 6126 PRESTLEY MILL RD
    SUITE H
    DOUGLASVILLE, GA
    ZIP 30134
  • Phone: (678) 715-2993

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NPI Details

ELITE FAMILY PRACTICE is a preferred provider organization in Douglasville, GA. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. ELITE FAMILY PRACTICE NPI is 1710236880. The provider is registered as an organization entity type.

The provider's business location address is:

6126 PRESTLEY MILL RD
SUITE H
DOUGLASVILLE, GA
ZIP 30134-623
Phone: (678) 715-2993
Fax: (678) 715-2827

The provider's authorized official is Delania W Miles .
The authorized official title is Office Manager and has the following contact phone number (678) 715-2993.

The CLIA number assigned to this NPI record is 11D0998471 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/5/2012 and was last updated on 9/5/2012.

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
1305R00000XPreferred Provider Organization041745GEORGIAYes

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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