Elite Medical Physicians PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

038076 Issued in GA

Legal business name

ELITE MEDICAL PHYSICIANS PC

Practice address

2892 Mountain Industrial Blvd
Tucker, GA 30084-3014

Phone

(678) 534-0452

Fax

(678) 534-1534

NPI assigned

May 10, 2007

Last updated

Jun 25, 2010By 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

Mrs. Louise A Brown

Title

Office Manager

Phone

(678) 534-0452

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1679787410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2892 MOUNTAIN INDUSTRIAL BLVD",
            "address_2": "P.O. BOX 201",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300843014",
            "telephone_number": "678-534-0452",
            "fax_number": "678-534-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2892 MOUNTAIN INDUSTRIAL BLVD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300843014",
            "telephone_number": "678-534-0452",
            "fax_number": "678-534-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL PHYSICIANS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LOUISE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "678-534-0452",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "038076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000596626F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caleb Lee Ebbets
• Delice S Echols, LCSW
• Editions of You Psychotherapy & Art Therapy LLC (Editions of You Therapy)
• Rebecca L Eisman, P.T., C.H.T.
• Roselyn Angel Ekperi, CPNP-PC
• Bruenetter Ellis Wright, ADDICTION COUNSELOR
• Angela Leslie Ellis, LPC
• Louisa Carns Ellis, LCSW
• Raven Ifoma Elosiebo-Walker, M.D.
• Rebekah M Elting, RN

• Specialist in Tucker, GA
• Providers in Tucker, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.