Clinica Medica Dr Rene Delgado, Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

014308 Issued in GA

Legal business name

CLINICA MEDICA DR RENE DELGADO, INC

Doing business as

Clinica Medica Familiar

Practice address

189 Medical Way
Suite B
Riverdale, GA 30274-4905

Phone

(770) 996-9681

Fax

(770) 996-9683

NPI assigned

Feb 22, 2009

Organization subpart

No

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

Authorized official

Name

Jack Dourron

Title

Practice Manager

Phone

(770) 996-9681

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• CLINICA MEDICA FAMILIAR Doing business as

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

{
    "created_epoch": "1235260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235260800000",
    "number": "1639319254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 MEDICAL WAY",
            "address_2": "SUITE B",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302744905",
            "telephone_number": "770-996-9681",
            "fax_number": "770-996-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 MEDICAL WAY",
            "address_2": "SUITE B",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302744905",
            "telephone_number": "770-996-9681",
            "fax_number": "770-996-9683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA MEDICA DR RENE DELGADO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-22",
        "last_updated": "2009-02-22",
        "status": "A",
        "authorized_official_last_name": "DOURRON",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "770-996-9681"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "027722",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "014308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000348675A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINICA MEDICA FAMILIAR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clayton Medical Supply Inc
• Clayton Mhddad (Clayton Center CSB)
• Clayton Mhddad (Clayton CSB)
• Kathryn Rose Clayton, MD
• Clinica Familiar Y Prenatal
• Clinica Medica Familiar, LLP
• Clinica Union, Inc
• Chyna Simone Cloud
• Jamyiah Laquan Coachman, CNM,WHNP-BC
• Charles Truman Colbert Jr., C.S.T./C.F.A.

• Obstetrics & Gynecology Physician in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2009; 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.