# POPHEALTHCARE MEDICAL SERVICES OF GA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Virginia
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407340292
- **Authorized official:** SUSAN PORTER (CREDENTIALING MANAGER)
- **Authorized official phone:** (615) 630-0988

## Contact information

- **Practice address:** 2 SUN CT STE 400, PEACHTREE CORNERS, GA 30092-2865
- **Practice address phone:** (615) 721-7020
- **Practice address fax:** (800) 266-5158
- **Mailing address:** 113 SEABOARD LN STE 200B, FRANKLIN, TN 37067-8282
- **Mailing address phone:** (615) 721-7024
- **Mailing address fax:** (800) 266-5158

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | — | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/15/2018
- **Last updated:** 02/04/2025