Provider Demographics
NPI:1669605234
Name:BETHANY BEND URGENT CARE, P.C.
Entity type:Organization
Organization Name:BETHANY BEND URGENT CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:770-521-6690
Mailing Address - Street 1:13081 HIGHWAY 9 N
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-5150
Mailing Address - Country:US
Mailing Address - Phone:770-521-6690
Mailing Address - Fax:770-521-6609
Practice Address - Street 1:13081 HIGHWAY 9 N
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-5150
Practice Address - Country:US
Practice Address - Phone:770-521-6690
Practice Address - Fax:770-521-6609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033707261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care