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Organization

MID PHYSICIAN NETWORK (KY), LLC

Active
Parent organization
MYIDEALDOCTOR LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
MYIDEALDOCTOR LLC
Authorized official
ADRIAN PAUL DAVIS (FOUNDER)
(855) 879-4332
Entity
Organization

Contact information

Practice address
5665 NEW NORTHSIDE DR STE 520, ATLANTA, GA 30328-4617
(855) 879-4332
Mailing address
PO BOX 6760, THOMASVILLE, GA 31758-6760

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
11/14/2017
Last updated
11/14/2017
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