Provider Demographics
NPI:1659845790
Name:FRANK J DEMARCO JR MD LLC
Entity Type:Organization
Organization Name:FRANK J DEMARCO JR MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEMARCO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:770-595-0491
Mailing Address - Street 1:465 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-2594
Mailing Address - Country:US
Mailing Address - Phone:770-595-0491
Mailing Address - Fax:
Practice Address - Street 1:4465 NELSON BROGDON BLVD
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-3487
Practice Address - Country:US
Practice Address - Phone:770-595-0491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty