Organization
COMMUNITY CARE MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANE A LING (DIRECTOR OF OP)
(678) 720-0422
Entity
Organization
Contact information
Practice address
5019 LAVISTA RD, TUCKER, GA 30084-3541
(678) 720-0422
(678) 720-0440
Mailing address
5019 LAVISTA RD, TUCKER, GA 30084-3541
(678) 720-0422
(678) 720-0440
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
156221
GA
Other
Enumeration date
02/14/2007
Last updated
08/22/2020
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