# PEACHTREE IMMEDIATE CARE FP, LLC

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

## Provider details

- **NPI number:** 1437194156
- **Authorized official:** SHANDI FAULK (VICE PRESIDENT, BILLING OPERATIONS)
- **Authorized official phone:** (678) 679-6471

## Contact information

- **Practice address:** 3827 JIMMY LEE SMITH PKWY, HIRAM, GA 30141-2630
- **Practice address phone:** (770) 222-8900
- **Practice address fax:** (770) 222-2757
- **Mailing address:** 590 LANIER AVE W, FAYETTEVILLE, GA 30214-1504
- **Mailing address phone:** (678) 688-9685
- **Mailing address fax:** (770) 626-3791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 06/17/2006
- **Last updated:** 09/24/2025