Provider Demographics
NPI:1407431174
Name:WESTSIDE URGENT CARE LLC
Entity Type:Organization
Organization Name:WESTSIDE URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTEVES
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:404-692-1050
Mailing Address - Street 1:2250 MARIETTA BLVD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318
Mailing Address - Country:US
Mailing Address - Phone:404-692-1050
Mailing Address - Fax:
Practice Address - Street 1:2250 MARIETTA BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318
Practice Address - Country:US
Practice Address - Phone:404-692-1050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESTSIDE URGENT CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty