Clarkston Family Medicine

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

019886 Issued in GA

Legal business name

CLARKSTON FAMILY MEDICINE

Practice address

3603 W Hill St
Clarkston, GA 30021-1207

Phone

(404) 299-7534

Fax

(404) 299-0608

NPI assigned

Aug 19, 2011

Last updated

Aug 19, 2011By 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

Dr. Minbh Tho Huynh, M.D.

Title

Sole Proprietor

Phone

(404) 299-7534

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clarkston Family medical center Former legal business name

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.

• Minh-Tho Huynh, M.D.

  • Family Medicine Physician
  • Clarkston, GA
  • NPI 1144218082
  NPD (past)

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1588944771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3603 W HILL ST",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300211207",
            "telephone_number": "404-299-7534",
            "fax_number": "404-299-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3603 W HILL ST",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300211207",
            "telephone_number": "404-299-7534",
            "fax_number": "404-299-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSTON FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-19",
        "status": "A",
        "authorized_official_last_name": "HUYNH",
        "authorized_official_first_name": "MINBH THO",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "404-299-7534",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "GA",
            "license": "019886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0085000391G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarkston Family medical center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Eunice Li Chay, DMD, MPH
• Huei-Chen Cheng, LPC
• Mariya George Cheriyampurathu
• Patrice Gibson Chishom, MD
• Clarkston Community Health Center, Inc.
• Clarkston Primary & Urgent Care, LLC
• Marqueta A Coffer
• Corinthianhomwcareservices (HomeCareServices)
• Kimberley Anne Crawford, PHD, MPH, RN, FNP-C
• Casey C Cudmore, RBT

• Point of Service in Clarkston, GA
• Providers in Clarkston, GA by specialty
• Point of Service in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; 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.