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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.

NPI Number 1134334832
LBN Legal business name POWDER SPRINGS MEDICAL CLINIC, INC.
Authorized official BOBBY HILL - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/14/2007
Last updated 02/14/2008 - About 18 years ago
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
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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