FAMILY PRACTICE OF ATLANTA LLC NPI 1790966976

NPI Information

  • NPI: 1790966976
  • Provider Name: FAMILY PRACTICE OF ATLANTA LLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 1428 SCOTT BLVD
    DECATUR, GA
    ZIP 30030
  • Phone: (404) 296-8100

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NPI Details

FAMILY PRACTICE OF ATLANTA LLC is a primary care clinic center in Decatur, GA. FAMILY PRACTICE OF ATLANTA LLC NPI is 1790966976. The provider is registered as an organization entity type.

The provider's business location address is:

1428 SCOTT BLVD
DECATUR, GA
ZIP 30030-424
Phone: (404) 296-8100
Fax: (404) 294-8467

The provider's authorized official is Sondi Saddia Moore-waters .
The authorized official title is Medical Director and has the following contact phone number (404) 296-8100.

The enumeration date for this NPI number is 11/16/2007 and was last updated on 3/4/2010.

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
1261QP2300XClinic/CenterPrimary Care031294GEORGIAYes

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
1GRP6402OTHERGEORGIAMEDICARE GROUP

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: 3/30/2025

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