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Organization

CARTERSVILLE URGENT CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFF RYDBURG (VP)
(615) 373-7600
Entity
Organization

Contact information

Practice address
824 WEST AVE, CARTERSVILLE, GA 30120-6100
(678) 721-5570
Mailing address
824 WEST AVE, CARTERSVILLE, GA 30120-6100
(678) 721-5570

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
GA
207Q00000X
Family Medicine Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
52230467001
BCBS OF GA
GA
01
5837030001
MEDICARE DME
SC
05
823710629A
GA
Enumeration date
06/06/2006
Last updated
06/04/2008
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