Pro-Medical Center LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PRO-MEDICAL CENTER LLC

Practice address

2090 Dunwoody Club Dr Ste 106-241
Atlanta, GA 30350-5434

Phone

(678) 736-6342

Fax

(678) 892-7428

NPI assigned

Oct 24, 2016

Last updated

Oct 24, 2016By 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

Mary Leach

Title

Billing

Phone

(678) 736-6342

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1255882353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 N SHALLOWFORD RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386308",
            "telephone_number": "678-736-6342",
            "fax_number": "678-892-7428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 DUNWOODY CLUB DR STE 106-241",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303505434",
            "telephone_number": "678-736-6342",
            "fax_number": "678-892-7428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "678-736-6342"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Procrown Prosthetics

• General Practice Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.