Provider Demographics
NPI:1851478028
Name:CATOOSA FAMILY MEDICINE
Entity Type:Organization
Organization Name:CATOOSA FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/PRACTICE ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GAREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-935-3926
Mailing Address - Street 1:313 BOYNTON DR
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-2737
Mailing Address - Country:US
Mailing Address - Phone:706-935-3926
Mailing Address - Fax:
Practice Address - Street 1:313 BOYNTON DR
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2737
Practice Address - Country:US
Practice Address - Phone:706-935-3926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6656Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER