# LIFETIME FAMILY MEDICINE,LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Lifetime Family Medicine LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053509216
- **Authorized official:** MRS. LISA H MILES (PRACTICE MANAGER)
- **Authorized official phone:** (770) 459-8449

## Contact information

- **Practice address:** 7869 VILLA RICA HWY, DALLAS, GA 30157-8638
- **Practice address phone:** (770) 459-8449
- **Mailing address:** 7869 VILLA RICA HWY, DALLAS, GA 30157-8638
- **Mailing address phone:** (770) 459-8449

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | 052082 | GA | — |

## Other

- **Enumeration date:** 10/11/2007
- **Last updated:** 03/10/2023