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SOUTH DEKALB FAMILY PHYSICIANS LLC NPI 1992970925


NPI Information

NPI: 1992970925
Provider Name: SOUTH DEKALB FAMILY PHYSICIANS, LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 11D0254605

Address:
5243 SNAPFINGER WOODS DR
SUITE 104
DECATUR, GA
ZIP 30035
Phone: (770) 981-5511
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SOUTH DEKALB FAMILY PHYSICIANS, LLC is a family medicine in Decatur, 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. SOUTH DEKALB FAMILY PHYSICIANS, LLC NPI is 1992970925. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5243 SNAPFINGER WOODS DR
SUITE 104
DECATUR, GA
ZIP 30035-000
Phone: (770) 981-5511
Fax: (770) 987-6928

The provider's authorized official is Adebayo A Akintobi .
The authorized official title is M.d. and has the following contact phone number (770) 981-5511.

The CLIA number assigned to this NPI record is 11D0254605 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/30/2008 and was last updated on 5/22/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine170009GEORGIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GRP6822MEDICARE PINGEORGIA

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: 4/28/2024

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