Lavista Family Medicine

LBN: Lavista Family Medicine
Lavista Family Medicine is an health care organization with primary practice located at 2910 N Druid Hills Rd Ne Suite A, Atlanta GA 30329-3919. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Lavista Family Medicine can be contacted via phone (404) 320-6050, or through Gorokhov, Mikhail via phone (404) 320-6050.

Contact Information

Primary practice address
2910 N Druid Hills Rd Ne Suite A Atlanta GA 30329-3919
Phone: (404) 320-6050
Fax: (404) 320-6080
Website:
Map and Directions
Authorized official contact:
Name: Gorokhov, Mikhail
Phone: (404) 320-6050

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X 039353 Georgia
Ambulatory Health Care Facilities / Primary Care 261QP2300X 042048 Georgia

Profile Details

NPI number 1538333497
LBN Legal business name Lavista Family Medicine
DBA Doing business as
Authorized official Gorokhov, Mikhail
Entity Organization
Organization subpart 1 No
Enumeration date Apr 22nd, 2008
Last updated Oct 24th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538333497 NPPES
Georgia MEDICAID 000662219E

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