Provider Demographics
NPI:1023368693
Name:FAMILY MEDICINE AND URGENT CARE, P.C.
Entity Type:Organization
Organization Name:FAMILY MEDICINE AND URGENT CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHASKAR
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-666-4430
Mailing Address - Street 1:4415 FRONT NINE DRIVE,
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6018
Mailing Address - Country:US
Mailing Address - Phone:678-666-4430
Mailing Address - Fax:678-666-4422
Practice Address - Street 1:4415 FRONT NINE DRIVE,
Practice Address - Street 2:SUITE 700
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6018
Practice Address - Country:US
Practice Address - Phone:678-666-4430
Practice Address - Fax:678-666-4422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055641207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty