Organization
ADVANCE CARE MEDICAL PCP GEORGIA, INC.
Active
Other names
Advance Care Medical Kennesaw GA
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN SMITH (EXECUTIVE CHAIRMAN)
(866) 668-2188
Entity
Organization
Contact information
Practice address
4300 BELLS FERRY RD NW, KENNESAW, GA 30144-1304
(866) 668-2188
Mailing address
3 SCHOOL ST STE 303, GLEN COVE, NY 11542-2548
(866) 668-2188
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/15/2022
Last updated
03/15/2022
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