Lifebrite Physician Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LIFEBRITE PHYSICIAN GROUP LLC

Practice address

3970 Five Forks Trickum Rd SW Ste a
Lilburn, GA 30047-2339

Phone

(855) 359-8629

Fax

(678) 310-1355

NPI assigned

Dec 10, 2018

Last updated

Dec 10, 2018By 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

Mr. Christian Fletcher

Title

Ceo

Phone

(855) 359-8629

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544400000000",
    "number": "1740751221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3970 FIVE FORKS TRICKUM RD SW STE A",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472339",
            "telephone_number": "855-359-8629",
            "fax_number": "678-310-1355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 FIVE FORKS TRICKUM RD SW STE A",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472339",
            "telephone_number": "855-359-8629",
            "fax_number": "678-310-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRITE PHYSICIAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-359-8629",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Lilburn, GA
• Providers in Lilburn, GA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.