Provider Demographics
NPI:1437343563
Name:PHYSICIANS IMMEDIATE MED OF DOUGLASVILLE, P.C.
Entity Type:Organization
Organization Name:PHYSICIANS IMMEDIATE MED OF DOUGLASVILLE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PAFUMY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:770-947-1112
Mailing Address - Street 1:3827 JIMMY LEE SMITH PKWY
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-2630
Mailing Address - Country:US
Mailing Address - Phone:770-947-1112
Mailing Address - Fax:770-947-1816
Practice Address - Street 1:9390 THE LANDING DRIVE
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135
Practice Address - Country:US
Practice Address - Phone:770-947-1112
Practice Address - Fax:770-947-1816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty