Organization
PARK CENTRAL FAMILY PRACTICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRIE A ALEXANDER (PRACTICE MANAGER)
(770) 981-2008
Entity
Organization
Contact information
Practice address
4367 NEW SNAPFINGER WOODS DR, DECATUR, GA 30035-2920
(770) 981-2008
(770) 981-6302
Mailing address
4367 NEW SNAPFINGER WOODS DR, DECATUR, GA 30035-2920
(770) 981-2008
(770) 981-6302
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172813090A
—
GA
Enumeration date
09/15/2006
Last updated
05/10/2021
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