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BOWDON FAMILY MEDICINE LLC NPI 1972936805


NPI Information

NPI: 1972936805
Provider Name: BOWDON FAMILY MEDICINE LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 11D2071751

Address:
307 W COLLEGE ST
BOWDON, GA
ZIP 30108
Phone: (770) 328-2006
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BOWDON FAMILY MEDICINE LLC is a family medicine in Bowdon, 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. BOWDON FAMILY MEDICINE LLC NPI is 1972936805. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

307 W COLLEGE ST
BOWDON, GA
ZIP 30108-309
Phone: (770) 328-2006

The provider's authorized official is Robert C Salter .
The authorized official title is Nurse Practitioner and has the following contact phone number (770) 328-2006.

The CLIA number assigned to this NPI record is 11D2071751 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/14/2013 and was last updated on 8/14/2013.


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
1363LF0000XNurse PractitionerFamilyRN 141751GEORGIANo
2207Q00000XFamily Medicine65367GEORGIAYes

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
1S84259MEDICARE UPINALABAMA

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

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