NPI age
15 years
Enumerated 2010-11-29
● Active Type 2 · Organization
Idlewood Medical Clinic Inc
Idlewood Medical Clinic Inc is 1 of 108 family medicine organizations in Georgia.
Primary specialty
Family Medicine
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
De La Vega
Ceo
Last NPPES update
2010-12-17
Source: monthly bulk 2026-05
How this organization compares
Across 108 active family medicine providers in Georgia.
NPI age
15 years
≈ at median (14 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2010 → 2026
2010-11Enumerated in NPPES
2010
2026
Where they practice
Primary practice location
2157 Idlewood Rd, Ste B
Tucker, GA 300844832
Mailing address
2157 Idlewood Rd, Ste B
Tucker, GA 300844832
Authorized official
Aida Rosa De La Vega
Ceo
📞 3053884383
Specialties
-
Family Medicine PrimaryThe NUCC recommends this code not be used. Choose a more appropriate code.
Practice context
Single-site organization. Only one practice location on file.
Provyx · Custom healthcare lists
Need all 108 Family Medicine providers in Georgia?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.