Provider Demographics
NPI:1336372150
Name:FPDOCTORS
Entity Type:Organization
Organization Name:FPDOCTORS
Other - Org Name:FAMILY PRACTICE DOCTORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:NWAIZUZU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-734-8186
Mailing Address - Street 1:11348 TARA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-6277
Mailing Address - Country:US
Mailing Address - Phone:800-734-8186
Mailing Address - Fax:
Practice Address - Street 1:11348 TARA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-6277
Practice Address - Country:US
Practice Address - Phone:800-734-8186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care