Eagles Landing Family Practice, Llc

LBN: Eagles Landing Family Practice, Llc
Eagles Landing Family Practice, Llc is an health care organization with primary practice located at 62 Kelly Rd , Mcdonough GA 30253-6012. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Eagles Landing Family Practice, Llc can be contacted via phone (770) 914-0116, or through Mitcham, Jeff via phone (770) 914-0116.

Contact Information

Primary practice address
62 Kelly Rd Mcdonough GA 30253-6012
Phone: (770) 914-0116
Fax: (770) 914-7703
Website:
Map and Directions
Authorized official contact:
Name: Mitcham, Jeff
Phone: (770) 914-0116

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 29378 Georgia

Profile Details

NPI number 1902907207
LBN Legal business name Eagles Landing Family Practice, Llc
DBA Doing business as
Authorized official Mitcham, Jeff
Entity Organization
Organization subpart 1 No
Enumeration date Sep 26th, 2006
Last updated Feb 6th, 2020 - about 6 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 1902907207 NPPES
Georgia Other 061407 BC/BS OF GA GROUP
Georgia Other CC6012 BC/BS OF GA GROUP

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