Organization
NATIONAL HEALTHCARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVERIL JOHNSON (MANAGER)
(770) 318-0476
Entity
Organization
Contact information
Practice address
135 EAGLES WALK STE 100, STOCKBRIDGE, GA 30281-7205
(770) 318-0476
Mailing address
950 HERRINGTON RD STE C64, LAWRENCEVILLE, GA 30044-7217
(770) 318-0476
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
38817
GA
207R00000X
Internal Medicine Physician
Primary
37708
GA
Other
Enumeration date
04/08/2016
Last updated
01/16/2020
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