Organization
AFC PHYSICIANS OF GEORGIA, PC
Active
Parent organization
AFC PHYSICIANS OF GEORGIA, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AFC PHYSICIANS OF GEORGIA, PC
Authorized official
MR. RANDY JOHANSEN (PRESIDENT)
(205) 421-2101
Entity
Organization
Contact information
Practice address
1095 WOODSTOCK RD, ROSWELL, GA 30075-0000
(678) 347-2464
(678) 347-2460
Mailing address
3700 CAHABA BEACH RD, BIRMINGHAM, AL 35242-5225
(205) 403-8902
(205) 421-2109
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202G708342
MEDICARE GROUP PTAN#
GA
Enumeration date
05/19/2014
Last updated
06/12/2020
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