Youngblood, Elaine C
Youngblood, Elaine C is an individual health care provider with primary practice located at 1045 Southcrest Dr Ste 110, Stockbridge GA 30281. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Youngblood, Elaine C can be contacted via phone (770) 507-2212.Contact Information
Primary practice address
1045 Southcrest Dr Ste 110
Stockbridge GA 30281
Phone: (770) 507-2212
Fax: (770) 507-2213
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 043513 | Georgia |
Profile Details
| NPI number | 1831132646 |
|---|---|
| LBN Legal business name | Youngblood, Elaine C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2006 |
| Last updated | Jan 30th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831132646 | NPPES |
| Georgia | MEDICAID | 000756599C | |
| Georgia | Other | 52671130 |
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