Medipractic LLC

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

Legal business name

MEDIPRACTIC LLC

Practice address

3955 Harrison Rd
Ste. 400
Loganville, GA 30052-8501

Phone

(770) 496-0326

Fax

(770) 492-9599

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. William E Willis, DC CDE1 DAAPM

Title

Sec

Phone

(770) 496-0326

Specialties & licenses 1

Addresses

Other names 1

• Medipractic Pain Management Doing business as

Locations

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356048000000",
    "number": "1699834697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 HARRISON RD",
            "address_2": "STE. 400",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300528501",
            "telephone_number": "770-496-0326",
            "fax_number": "770-492-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 HARRISON RD",
            "address_2": "STE. 400",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300528501",
            "telephone_number": "770-496-0326",
            "fax_number": "770-492-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2012-12-21",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SEC",
        "authorized_official_telephone_number": "770-496-0326",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC CDE1 DAAPM"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medipractic Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Meadows, PTA
• Med Fast PC
• Medcare Transport Inc
• Medical Elite Network Corp
• Nilton D Medina, MD
• Medipractic LLC
• Morgan Greer Medley, PHARMD
• Meekness Home Care Services LLC
• Jasmine Meeks
• Lawanda June Meers, PHARMD

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Loganville, GA
• Providers in Loganville, GA by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; 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.