# SOUTH FULTON PRIMARY CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174851919
- **Authorized official:** LOGAN ALLEN (VP CLIENT OPERATIONS)
- **Authorized official phone:** (678) 252-2137

## Contact information

- **Practice address:** 1203 CLEVELAND AVE, SUITE 1A, EAST POINT, GA 30344-3417
- **Practice address phone:** (404) 305-8900
- **Practice address fax:** (404) 305-8099
- **Mailing address:** 2220 WISTERIA DR, SUITE 208, SNELLVILLE, GA 30078-2656
- **Mailing address phone:** (678) 252-2137
- **Mailing address fax:** (678) 336-7099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 046202 | GA | Yes |

## Other

- **Enumeration date:** 12/04/2009
- **Last updated:** 12/04/2009