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Contact Information

POWDER SPRINGS MEDICAL CLINIC, INC.
4045-B LINDLEY CIR
POWDER SPRINGS, GA30127
 Phone: 770-943-1636
 Fax: 770-943-7941
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for POWDER SPRINGS MEDICAL CLINIC INC · (Female)

NPI # 1134334832
Status Active
Credentials
Entity Individual
Enumeration date 05/14/2007
Last updated 02/14/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 019698
  • GA Other 4569669 AETNA
  • GA Other 10041190 AMERIGROUP
  • GA Other 52143080 BCBS
  • GA Other 3661647 CIGNA
  • GA Other GRP3770 MEDICARE GROUP
  • GA Other P00256198 RAILROAD MEDICARE
  • GA Other 0100673 UNITED HEALTHCARE
  • GA Other 314139 WELLCARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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