Provider Demographics
NPI:1538657549
Name:GEORGIA COMPREHENSIVE FAMILY CLINIC & NATURAL HEALTH
Entity Type:Organization
Organization Name:GEORGIA COMPREHENSIVE FAMILY CLINIC & NATURAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OBIALOR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:404-547-2859
Mailing Address - Street 1:4346 JONES BRIDGE
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092
Mailing Address - Country:US
Mailing Address - Phone:404-547-2859
Mailing Address - Fax:678-250-9075
Practice Address - Street 1:1065 PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044
Practice Address - Country:US
Practice Address - Phone:404-547-2859
Practice Address - Fax:678-250-9075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
GA206149363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty