Provider Demographics
NPI:1528496353
Name:GEORGIA PHYSICIAN ASSOCIATES, PC
Entity type:Organization
Organization Name:GEORGIA PHYSICIAN ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEECHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-245-6246
Mailing Address - Street 1:2000 VILLAGE PROFESSIONAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-8498
Mailing Address - Country:US
Mailing Address - Phone:678-661-4545
Mailing Address - Fax:
Practice Address - Street 1:2000 VILLAGE PROFESSIONAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-8498
Practice Address - Country:US
Practice Address - Phone:678-661-4545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty