Organization · Type 2 NPI
Locust Grove Family Medicine
Non-Pharmacy Dispensing Site · Locust Grove, GA
NPI number
1629169164
Active
Practice location
3778 Highway 42
Locust Grove, GA 30248-3632
Fax (678) 610-6025
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | 053715 (GA) |
| Non-Pharmacy Dispensing Site Primary | 332900000X | 053715 (GA) |
Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
5 other providers at this address
- Sushrut LLCFamily Medicine Physician Locust Grove, GA NPI 1013740414
- Sushrut LLCFamily Medicine Physician Locust Grove, GA NPI 1710710116
- Caridad M. Monteilh, FNP-CFamily Nurse Practitioner Locust Grove, GA NPI 1346333986
- Chetan Sharma, MDFamily Medicine Physician Locust Grove, GA NPI 1871763011
- Nimisha J. Trivedi, MDFamily Medicine Physician Locust Grove, GA NPI 1629074299
Other non-pharmacy dispensing site providers in Locust Grove
About NPI 1629169164
Locust Grove Family Medicine's National Provider Identifier is 1629169164, issued on Sep 28, 2006. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Locust Grove, GA. The record was last updated on Mar 14, 2016.