Provider Demographics
NPI:1629122684
Name:PRIORITY PRIMARY CARE
Entity Type:Organization
Organization Name:PRIORITY PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-963-7637
Mailing Address - Street 1:3540 DULUTH PARK LN STE 170
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8721
Mailing Address - Country:US
Mailing Address - Phone:770-476-2273
Mailing Address - Fax:770-476-2273
Practice Address - Street 1:3540 DULUTH PARK LN STE 170
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8721
Practice Address - Country:US
Practice Address - Phone:770-476-2273
Practice Address - Fax:770-476-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA022794207R00000X
GA056662207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP3407Medicare UPIN