Organization
316 FAMILY MEDICINE
Active
Parent organization
316 HEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
316 HEALTHCARE
Authorized official
NOELLE SMITH (PRACTICE MANAGER)
(770) 634-8905
Entity
Organization
Contact information
Practice address
222 GORDON ST, BREMEN, GA 30110-1519
(770) 537-1234
(770) 537-1237
Mailing address
PO BOX 728, BREMEN, GA 30110-0728
(770) 537-1234
(770) 537-1235
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
059986
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059986
STATE LICENSE NUMBER
GA
01
—
1003540147
NPI
—
01
—
1023769965
NPI
—
01
—
1154862910
NPI
—
01
—
1184171886
NPI
—
01
—
1225441967
NPI
—
01
—
1265154884
NPI
—
01
—
1265208318
NPI
—
01
—
1295123792
NPI
—
01
—
1407005085
NPI
—
01
—
1407291925
NPI
—
01
—
1407443252
NPI
—
01
—
1457021628
NPI
—
01
—
1598047730
NPI
—
01
—
1669710786
NPI
—
01
—
1669982088
NPI
—
01
—
1811282346
NPI
—
01
—
1821630971
NPI
—
01
—
1841754611
NPI
—
01
—
1871781476
NPI
—
01
—
1932556453
NPI
—
01
—
1932730306
NPI
—
01
—
1952854572
NPI
—
01
—
1952951535
NPI
—
01
—
1962851352
NPI
—
Enumeration date
07/24/2017
Last updated
03/20/2025
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