NPI age
16 years
Enumerated 2009-09-01
● Active Type 2 · Organization
Eagle Drive Family Medicine Pc
Eagle Drive Family Medicine Pc is 1 of 661 general practice organizations in Georgia.
Primary specialty
General Practice
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Manrique
President
Last NPPES update
2012-01-25
Source: monthly bulk 2026-05
How this organization compares
Across 661 active general practice providers in Georgia.
NPI age
16 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2009 → 2026
2009-09Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
1816 Eagle Dr, Suite 200-B
Woodstock, GA 301898272
Mailing address
1816 Eagle Dr, Suite 200-B
Woodstock, GA 301898272
Authorized official
Richard Leon Manrique, M.D.
President
📞 6784455995
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Ryan Dye, PTA Physical Therapy Assistant NPI 1013887025
- Scott Harden, D.D.S. Dentist NPI 1538210695
- Richard Manrique, MD General Practice NPI 1548299332
- Julius Park, D.M.D. Dentist NPI 1710022942
- Robert Riesing, PT,DPT Physical Therapist NPI 1336420017
Specialties
-
General Practice PrimaryA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Practice context
Multi-provider organization. 5 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.