Organization
NORTH GEORGIA PRIMARY CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARJORIE S BUCHANAN CPC, CH-CBS (PRACTICE MANAGER)
(706) 633-4132
Entity
Organization
Contact information
Practice address
14 SAMMY MCGHEE BLVD STE 204, JASPER, GA 30143-7723
(706) 253-3842
(706) 253-3842
Mailing address
14 SAMMY MCGHEE BLVD STE 204, JASPER, GA 30143-7723
(706) 253-3842
(706) 253-3842
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
032586
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000412618I
—
GA
05
—
762424450A
—
GA
01
—
GRP4247
MEDICARE GROUP FOR NORTH
GA
Enumeration date
05/30/2007
Last updated
12/02/2019
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