Provider Demographics
NPI:1639254873
Name:FAMILY HEALTH CENTER PC
Entity Type:Organization
Organization Name:FAMILY HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:GADDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-607-8111
Mailing Address - Street 1:970 JOE FRANK HARRIS PKWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120
Mailing Address - Country:US
Mailing Address - Phone:770-607-8111
Mailing Address - Fax:770-607-4111
Practice Address - Street 1:970 JOE FRANK HARRIS PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120
Practice Address - Country:US
Practice Address - Phone:770-607-8111
Practice Address - Fax:770-607-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA42248207Q00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00723445HMedicaid
08BBTRXMedicare ID - Type Unspecified
B59632Medicare UPIN