Provider Demographics
NPI:1134362890
Name:JOHNS CREEK FAMILY PHYSICIANS, LLC
Entity type:Organization
Organization Name:JOHNS CREEK FAMILY PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-373-7600
Mailing Address - Street 1:4940 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-1599
Mailing Address - Country:US
Mailing Address - Phone:770-441-2300
Mailing Address - Fax:866-910-5954
Practice Address - Street 1:4940 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-1599
Practice Address - Country:US
Practice Address - Phone:770-441-2300
Practice Address - Fax:866-910-5954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-10
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty