24 On Physicians, P.C.

Organization Active NPI Internal Medicine Physician · Riverdale, GA

NPI 1366779274 · NPPES record last updated Nov 13, 2009

Key facts

NPI
1366779274
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
24 ON PHYSICIANS, P.C.
Practice address
11 Upper Riverdale Rd
Riverdale, GA 30274-2600
Phone
(770) 897-7107
Fax
(770) 897-7109
NPI assigned
Nov 13, 2009
Organization subpart
No

Authorized official

Name
Mr. Dan A. Fuller
Title
VP/Secretary
Phone
(770) 740-0895

Corporate family (same tax ID) 3

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

National Provider Directory

Tax ID family
24 On Physicians PC (4 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207R00000X Yes

Addresses

Primary practice location

11 Upper Riverdale Rd
Riverdale, GA 30274-2600

Mailing address

PO Box 403631
Atlanta, GA 30384-3631
Phone (770) 740-0895

Other providers in Riverdale, GA

All providers in Riverdale, GA · Internal Medicine Physician in Georgia

Sources for this page

Verify at the official NPI Registry.