Provider Demographics
NPI:1629222419
Name:NEW HOPE URGENT CARE LLC
Entity Type:Organization
Organization Name:NEW HOPE URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MAYFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACEP
Authorized Official - Phone:770-655-2020
Mailing Address - Street 1:49 HOSIERY MILL RD STE 124
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-1687
Mailing Address - Country:US
Mailing Address - Phone:770-443-6111
Mailing Address - Fax:
Practice Address - Street 1:49 HOSIERY MILL RD STE 124
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-1687
Practice Address - Country:US
Practice Address - Phone:770-443-6111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-06
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051355261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care