Organization
AFC PHYSICIANS OF GEORGIA, PC
Active
Parent organization
AMERICAN FAMILY CARE, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERICAN FAMILY CARE, INC
Authorized official
RANDY JOHANSEN (PRESIDENT)
(205) 403-8902
Entity
Organization
Contact information
Practice address
6509 GATEWAY RD, COLUMBUS, GA 31909-5681
(706) 243-0174
(706) 243-0178
Mailing address
2147 RIVERCHASE OFFICE RD, BIRMINGHAM, AL 35244-1836
(205) 403-8902
(205) 421-2109
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202G708342
MCR PTAN
GA
Enumeration date
01/03/2014
Last updated
01/03/2014
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