Ideal Medical Group LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

022068 Issued in GA

Legal business name

IDEAL MEDICAL GROUP LLC

Practice address

3523 Buford Hwy
Ste - 100
Atlanta, GA 30329-1279

Phone

(404) 634-4550

Fax

(404) 634-8550

NPI assigned

Feb 3, 2009

Last updated

Feb 3, 2009By 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

George Tucker, MDNPI 1831261114

Title

Ceo/Owner

Phone

(404) 634-4550

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• George Tucker, MD

  • Obstetrics & Gynecology Physician
  • Atlanta, GA
  • NPI 1831261114
  NPD (past) Authorized official
• Shelia Handley Palmer, PA-C

  • Medical Physician Assistant
  • Atlanta, GA
  • NPI 1861686347
  NPD (past)
• Simon E. Portee, M.D.

  • Emergency Medicine Physician
  • Greensboro, GA
  • NPI 1366469108
  NPD (past)

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

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233619200000",
    "number": "1801034574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3523 BUFORD HWY",
            "address_2": "STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30329",
            "telephone_number": "404-634-4550",
            "fax_number": "404-634-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3523 BUFORD HWY",
            "address_2": "STE - 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303291279",
            "telephone_number": "404-634-4550",
            "fax_number": "404-634-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-03",
        "last_updated": "2009-02-03",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "404-634-4550",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "022068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ideal Dental Chastain Park PC
• Ideal Gynecology
• Ideal Gynecology 2, LLC
• Ideal Health Center
• Ideal Medical Center, LLC
• Ideal Urgent Care, PC
• Caroline Idehen
• Christian Idehen
• Clare Idehen, MD
• Thaer Idrees, M.D.

• Obstetrics & Gynecology Physician in Atlanta, GA
• Providers in Atlanta, 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 3, 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.