Provider Demographics
NPI:1902438617
Name:NORTHEAST GEORGIA HOUSE CALLS LLC
Entity Type:Organization
Organization Name:NORTHEAST GEORGIA HOUSE CALLS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-202-6842
Mailing Address - Street 1:2205 BARNETT SHOALS RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-3605
Mailing Address - Country:US
Mailing Address - Phone:706-548-1555
Mailing Address - Fax:888-532-0853
Practice Address - Street 1:2205 BARNETT SHOALS RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-3605
Practice Address - Country:US
Practice Address - Phone:706-548-1555
Practice Address - Fax:888-532-0853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty