Provider Demographics
NPI:1417363797
Name:DR 2 TRAVEL, LLC
Entity Type:Organization
Organization Name:DR 2 TRAVEL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:STARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-951-3983
Mailing Address - Street 1:2011 COMMERCE DR N
Mailing Address - Street 2:SUITE 21
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3538
Mailing Address - Country:US
Mailing Address - Phone:678-951-3983
Mailing Address - Fax:678-487-8306
Practice Address - Street 1:2011 COMMERCE DR N
Practice Address - Street 2:SUITE 21
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3538
Practice Address - Country:US
Practice Address - Phone:678-951-3983
Practice Address - Fax:678-487-8306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-07
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA71570261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
202G700017Medicare UPIN