Organization
JUBILEE PRIMARY CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVRIL PATRICE DAISLEY SHONGO MD (PROVIDER)
(678) 783-4860
Entity
Organization
Contact information
Practice address
3312 HEATHCHASE LN, SUWANEE, GA 30024-4639
(678) 783-4860
(678) 940-0509
Mailing address
2090 LAWRENCEVILLE SUWANEE RD, SUITE A#519, SUWANEE, GA 30024
(678) 783-4860
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
10/12/2020
Last updated
10/30/2020
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