Provider Demographics
NPI:1841792611
Name:MEDICAL AFFILIATES INC
Entity Type:Organization
Organization Name:MEDICAL AFFILIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEECHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-245-6244
Mailing Address - Street 1:2000 VILLAGE PROFESSIONAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-8499
Mailing Address - Country:US
Mailing Address - Phone:678-245-6244
Mailing Address - Fax:770-874-0028
Practice Address - Street 1:2000 VILLAGE PROFESSIONAL DR STE 200
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-8499
Practice Address - Country:US
Practice Address - Phone:678-245-6244
Practice Address - Fax:770-874-0028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty