Provider Demographics
NPI:1629318662
Name:STAT MEDICAL CARE INC
Entity Type:Organization
Organization Name:STAT MEDICAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DUGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-623-6773
Mailing Address - Street 1:9690 VENTANA WAY
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30022-6394
Mailing Address - Country:US
Mailing Address - Phone:770-623-6773
Mailing Address - Fax:770-232-9882
Practice Address - Street 1:9690 VENTANA WAY
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30022-6394
Practice Address - Country:US
Practice Address - Phone:770-623-6773
Practice Address - Fax:770-232-9882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA025341261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care