Northeast Georgia Physicians Group, Inc.

LBN: Northeast Georgia Physicians Group, Inc.
Northeast Georgia Physicians Group, Inc. is an health care organization with primary practice located at 115 Towne Center Pkwy Suite 113, Hoschton GA 30548-2213. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as the primary health care specialty. Northeast Georgia Physicians Group, Inc. can be contacted via phone (706) 658-2452, or through Glover, J. Shannon via phone (770) 219-7826.

Contact Information

Primary practice address
115 Towne Center Pkwy Suite 113 Hoschton GA 30548-2213
Phone: (706) 658-2452
Fax: (706) 658-2462
Website:
Map and Directions
Authorized official contact:
Name: Glover, J. Shannon
Phone: (770) 219-7826

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 60363 Georgia

Profile Details

NPI number 1104009059
LBN Legal business name Northeast Georgia Physicians Group, Inc.
DBA Doing business as
Authorized official Glover, J. Shannon
Entity Organization
Organization subpart 1 No
Enumeration date Dec 14th, 2007
Last updated Apr 15th, 2011 - about 14 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 1104009059 NPPES
Georgia MEDICAID 574554373A

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