Provider Demographics
NPI:1205380995
Name:SEASONS MEDICAL GROUP OF GEORGIA PC
Entity Type:Organization
Organization Name:SEASONS MEDICAL GROUP OF GEORGIA PC
Other - Org Name:ACCENTCARE MEDICAL GROUP OF GEORGIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-692-1000
Mailing Address - Street 1:6400 SHAFER CT STE 300A
Mailing Address - Street 2:
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-4914
Mailing Address - Country:US
Mailing Address - Phone:847-692-1000
Mailing Address - Fax:
Practice Address - Street 1:11675 GREAT OAKS WAY STE 310
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-2402
Practice Address - Country:US
Practice Address - Phone:404-250-4950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-10
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty