Organization
FAMILY FIRST HEALTHCARE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN D BLAKE M.D. (OWNER)
(770) 739-1233
Entity
Organization
Contact information
Practice address
939 THORNTON RD, LITHIA SPRINGS, GA 30122-2634
(770) 739-1233
(770) 948-4930
Mailing address
939 THORNTON RD, LITHIA SPRINGS, GA 30122-2634
(770) 739-1233
(770) 948-4930
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
040613
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000687409D
—
GA
Enumeration date
06/03/2009
Last updated
02/03/2012
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