Provider Demographics
NPI:1306040225
Name:COMPLETE CARE OF GEORGIA, P.C.
Entity Type:Organization
Organization Name:COMPLETE CARE OF GEORGIA, P.C.
Other - Org Name:HEALING INNOVATIONS, P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-808-8500
Mailing Address - Street 1:PO BOX 3760
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30031-3760
Mailing Address - Country:US
Mailing Address - Phone:770-808-8500
Mailing Address - Fax:
Practice Address - Street 1:5040 SNAPFINGER WOODS DR
Practice Address - Street 2:SUITE 201
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-4020
Practice Address - Country:US
Practice Address - Phone:770-808-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA042997207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00834061BMedicaid
GA08BBTGBMedicare PIN
GA00834061BMedicaid