Professional Park Medical Services, P.C.
LBN: Professional Park Medical Services, P.C.
Professional Park Medical Services, P.C. is an health care organization with primary practice located at Suite 202 100 Professional Park, Carrollton GA 30117. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty.
Professional Park Medical Services, P.C. can be contacted via phone (770) 832-6861, or through Gordon, Jefferson Taylor via phone (770) 832-6861.
Contact Information
Primary practice address
Suite 202 100 Professional Park
Carrollton GA 30117
Phone: (770) 832-6861
Fax: (770) 832-9432
Website:
Authorized official contact:
Name: Gordon, Jefferson Taylor Doctor of Medicine (MD)
Phone: (770) 832-6861
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X |
Profile Details
| NPI number | 1386662849 |
|---|---|
| LBN Legal business name | Professional Park Medical Services, P.C. |
| DBA Doing business as | |
| Authorized official | Gordon, Jefferson Taylor Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Mar 4th, 2016 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386662849 | NPPES |
| Georgia | Other | CJ2154 | MEDICARE RAILROAD |
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