# BOLD PRIMARY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** American Family Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275300287
- **Authorized official:** LEIA DAWSON DO (MEDICAL DIRECTOR/ EXECUTIVE OFFICER)
- **Authorized official phone:** (470) 250-1492

## Contact information

- **Practice address:** 1401 JOHNSON FERRY RD STE 390B, MARIETTA, GA 30062-6495
- **Practice address phone:** (470) 250-1492
- **Practice address fax:** (470) 235-7311
- **Mailing address:** 1401 JOHNSON FERRY RD STE 390B, MARIETTA, GA 30062-6495
- **Mailing address phone:** (470) 250-1492
- **Mailing address fax:** (470) 235-7311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/08/2023
- **Last updated:** 05/13/2024