# MIDWAY HEALTHCARE LLC

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

## Provider details

- **NPI number:** 1669848388
- **Authorized official:** JENNIFER L DORGAN (TREASURER)
- **Authorized official phone:** (770) 667-0099

## Contact information

- **Practice address:** 4914 ATLANTA HWY, ALPHARETTA, GA 30004-2921
- **Practice address phone:** (770) 667-0099
- **Practice address fax:** (770) 667-0092
- **Mailing address:** 4914 ATLANTA HWY, ALPHARETTA, GA 30004-2921
- **Mailing address phone:** (770) 667-0099
- **Mailing address fax:** (770) 667-0092

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 08/17/2015
- **Last updated:** 08/17/2015