Organization
INTOWN FAMILY PRACTICE & SPORTS MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE LEO GOLUSINSKI JR. M.D. (OWNER)
(404) 577-7800
Entity
Organization
Contact information
Practice address
285 BOULEVARD AVE NE, SUITE 640, ATLANTA, GA 30312-4212
(404) 577-7800
(404) 577-7810
Mailing address
285 BOULEVARD AVE NE, SUITE 640, ATLANTA, GA 30312-4212
(404) 577-7800
(404) 577-7810
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
038777
GA
261QP2300X
Primary Care Clinic/Center
20330
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0191191
UNITED HEALTHCARE
GA
01
—
1013698006
CIGNA HEALTHCARE
GA
01
—
160928
COVENTRY HEALTHCARE
GA
01
—
4546534
AETNA
GA
01
—
52476640002
BCBS OF GA
GA
01
—
776894
FIRST HEALTH
GA
Enumeration date
09/09/2010
Last updated
09/09/2010
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