Organization
CONYERS FAMILY PRACTICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA ANN PARRY (OFFICE MANAGER)
(770) 483-4951
Entity
Organization
Contact information
Practice address
1080 GREEN STREET SE, CONYERS, GA 30012
(770) 483-4951
Mailing address
1080 GREEN STREET SE, CONYERS, GA 30012
(770) 483-4951
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP3602
MEDICARE GROUP
GA
Enumeration date
04/23/2007
Last updated
07/30/2008
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