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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adult Medicine |
207QA0505X | 08 | Physician/Family Practice | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI Number | 1700526142 |
| LBN Legal business name | J & G FAMILY PRACTICE LLC |
| Authorized official | NGUM AVWONTOM - (PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 04/01/2022 |
| Last updated | 04/01/2022 - About 4 years ago |
| Identifiers | n/a |
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J & G FAMILY PRACTICE LLC
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J & G FAMILY PRACTICE LLC