FORD CLINIC INC NPI 1710965900

NPI Information

NPI: 1710965900
Provider Name: FORD CLINIC, INC

Doing Business As: NORTHEAST GEORGIA MEDICAL ASSOCIATES

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
11973 AUGUSTA RD
LAVONIA, GA
ZIP 30553
Phone: (706) 356-8181
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FORD CLINIC, INC is a primary care clinic center in Lavonia, GA. FORD CLINIC, INC NPI is 1710965900. The provider is registered as an organization entity type.
The provider Is Doing Business As Northeast Georgia Medical Associates.

The provider's business location address is:

11973 AUGUSTA RD
LAVONIA, GA
ZIP 30553-283
Phone: (706) 356-8181
Fax: (706) 356-8081

The provider's authorized official is Nicole Ford .
The authorized official title is Office Manager and has the following contact phone number (706) 245-7380.

The CLIA number assigned to this NPI record is 11D1103712 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/6/2006 and was last updated on 8/22/2020.

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
1	261QP2300X	Clinic/Center	Primary Care			Yes
2	261QP3300X	Clinic/Center	Pain			X

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	85001253G	MEDICAID	GEORGIA
2	132982	MEDICAID	SOUTH CAROLINA

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

NPI Synchronization or Removal

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