Executive Medical Associates P.C.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

RN162951 Issued in GA

Legal business name

EXECUTIVE MEDICAL ASSOCIATES P.C.

Practice address

4426 Hugh Howell Rd
Suite B303
Tucker, GA 30084-4918

Phone

(770) 572-7574

NPI assigned

May 8, 2015

Last updated

May 8, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lee Wilkes, M.D.NPI 1568441871

Title

Owner/Medical Director

Phone

(770) 572-7574

Specialties & licenses 1

Addresses

Tax ID family

Executive Medical Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Executive Medical Associates

  • Internal Medicine Physician
  • Tucker, GA
  • NPI 1518297266
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lee Wilkes, MD

  • Internal Medicine Physician
  • Tucker, GA
  • NPI 1568441871
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1104204379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 BEAMS WAY",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301572517",
            "telephone_number": "678-779-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4426 HUGH HOWELL RD",
            "address_2": "SUITE B303",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844918",
            "telephone_number": "770-572-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE MEDICAL ASSOCIATES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-08",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "WILKES",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-572-7574",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "RN162951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sylvia Evans
• Tavia Foster Evans, CCC-SLP
• Aleshia Evers
• Execellence in Healthcare
• Executive Medical Associates
• Express Professional Homecare,LLC.
• Eyes-Rite,Inc
• Faebris Medical & Community Education
• Brittany Fagan, LCSW
• Martino Sylvester Faggioni Jr., DDS

• Clinic/Center in Tucker, GA
• Providers in Tucker, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.