Provider Demographics
NPI:1861565525
Name:FAMILY PHYSICIANS, PA
Entity type:Organization
Organization Name:FAMILY PHYSICIANS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOY
Authorized Official - Middle Name:O
Authorized Official - Last Name:GAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:770-867-9186
Mailing Address - Street 1:314 N BROAD ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-8206
Mailing Address - Country:US
Mailing Address - Phone:770-867-9186
Mailing Address - Fax:770-867-2163
Practice Address - Street 1:314 N BROAD ST
Practice Address - Street 2:SUITE 130
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-2191
Practice Address - Country:US
Practice Address - Phone:770-867-9186
Practice Address - Fax:770-867-2163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH45673Medicare UPIN
GAD40182Medicare UPIN
GAD29781Medicare UPIN
GAGRP1062Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
GAD45418Medicare UPIN