# IDEAL MEDICAL CENTER, LLC

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

## Provider details

- **NPI number:** 1518011790
- **Authorized official:** MR. ALEX CAMPOS (OWNER / PRESIDENT)
- **Authorized official phone:** (678) 812-2625

## Contact information

- **Practice address:** 3523 BUFORD HWY NE, SUITE 100, ATLANTA, GA 30329-1201
- **Practice address phone:** (678) 812-2625
- **Mailing address:** 3039 PREMIERE PKWY, SUITE 100, DULUTH, GA 30097-4905
- **Mailing address phone:** (678) 812-2625

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | — | NULL | — |
| 183500000X | Pharmacist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | NULL | — |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 01/23/2007
- **Last updated:** 01/22/2008