Organization
MASON PRIMARY CARE CLINIC, LP
Active
Organization
MASON PRIMARY CARE CLINIC, LP
Active
Other names
Mason Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
MISSY MARTIN (BILLING MANAGER)
(770) 622-3114
Entity
Organization
Contact information
Practice address
3500 MCCLURE BRIDGE RD, DULUTH, GA 30096-3131
(770) 476-3636
(770) 476-5845
Mailing address
PO BOX 248, DULUTH, GA 30096-0005
(770) 476-3636
(770) 476-5845
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000364339S
—
GA
05
—
000817363D
—
GA
05
—
055002346A
—
GA
Enumeration date
05/10/2006
Last updated
01/13/2010
Update your record
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