# NORTH FULTON PRIMARY CARE-WILLEO ROAD, LLC

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

## Provider details

- **NPI number:** 1316343999
- **Authorized official:** MR. WESLEY O. JAMES (REGIONAL CFO, TENET)
- **Authorized official phone:** (404) 265-5009

## Contact information

- **Practice address:** 9420 WILLEO RD, SUITE 206, ROSWELL, GA 30075-6772
- **Practice address phone:** (470) 235-4859
- **Practice address fax:** (470) 235-4860
- **Mailing address:** PO BOX 743119, ATLANTA, GA 30374-3119
- **Mailing address phone:** (470) 235-4859
- **Mailing address fax:** (470) 235-4860

## Taxonomy

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

## Other

- **Enumeration date:** 11/10/2014
- **Last updated:** 06/16/2016