Organization
PRIMARY CARE CLINICS OF GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID LEON HOCKER M.D., M.R.O. (MEDICAL DIRECTOR)
(770) 536-1004
Entity
Organization
Contact information
Practice address
1240 JESSE JEWELL PKWY SE, SUITE 370, GAINESVILLE, GA 30501-3862
(770) 536-1004
(770) 536-0905
Mailing address
1240 JESSE JEWELL PKWY SE, SUITE 370, GAINESVILLE, GA 30501-3861
(770) 536-1004
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
041138
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000686463B
—
GA
01
—
1013961846
BLUE CROSS AND BLUE SHIEL
GA
01
—
158736300
US DOL OWCP
GA
01
—
P00089388
MEDICARE RAILROAD
GA
Enumeration date
05/19/2006
Last updated
07/21/2008
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