Mountain Park Primary Care Center
LBN: Mountain Park Primary Care Center
Mountain Park Primary Care Center is an health care organization with primary practice located at 1755 E Park Place Blvd , Stone Mountain GA 30087-3459. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as the primary health care specialty.
Mountain Park Primary Care Center can be contacted via phone (770) 469-2040, or through Noyd, William Walter via phone (770) 469-2040.
Contact Information
Primary practice address
1755 E Park Place Blvd
Stone Mountain GA 30087-3459
Phone: (770) 469-2040
Fax: (770) 469-7010
Website:
Authorized official contact:
Name: Noyd, William Walter Doctor of Medicine (MD)
Phone: (770) 469-2040
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 021187 | Georgia |
Profile Details
| NPI number | 1497955678 |
|---|---|
| LBN Legal business name | Mountain Park Primary Care Center |
| DBA Doing business as | |
| Authorized official | Noyd, William Walter Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 24th, 2007 |
| Last updated | Jul 24th, 2007 - about 19 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 | 1497955678 | NPPES |
| Georgia | Other | 10036820 | AMERIGROUP |
| Georgia | MEDICAID | 00203761K | AMERIGROUP |
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