NPI age
9 years
Enumerated 2016-07-15
Across 462 active clinic/center providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003122845A | |
| 01 (GA) | 111961 | MEDICARE PTAN |
Single-site organization. Only one practice location on file.
Subpart of J C Lewis Primary Health Care Center.
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