# PRIMARY CARE GROUP OF WEST GEORGIA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PRIMARY CARE GROUP OF WEST GEORGIA
- **Other names:** Pulmonary Rehab
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1598938185
- **Legal business name:** PRIMARY CARE GROUP OF WEST GEORGIA
- **Authorized official:** MRS. TREBBA PUTNAM CPC MPA (ADMINISTRATOR)
- **Authorized official phone:** (770) 838-1570

## Contact information

- **Practice address:** 7869 VILLA RICA HWY, DALLAS, GA 30157-8638
- **Practice address phone:** (770) 838-1570
- **Practice address fax:** (770) 838-1722
- **Mailing address:** 100 PROFESSIONAL PL, SUITE 204, CARROLLTON, GA 30117-3874
- **Mailing address phone:** (770) 838-1570
- **Mailing address fax:** (770) 838-1722

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | Yes |
| 207RP1001X | Pulmonary Disease Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/04/2008
- **Last updated:** 04/04/2008