Eagles Landing Primary Care Specialists PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EAGLES LANDING PRIMARY CARE SPECIALISTS PC

Practice address

3001 S Cobb Dr SE
Suite 103
Smyrna, GA 30080-7809

Phone

(678) 556-9460

NPI assigned

Jul 26, 2007

Organization subpart

No

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

Authorized official

Name

Miguel E Stubbs

Title

Partner

Phone

(678) 556-9460

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1821288754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 S COBB DR SE",
            "address_2": "SUITE 103",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300807809",
            "telephone_number": "678-556-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 S COBB DR SE",
            "address_2": "SUITE 103",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300807809",
            "telephone_number": "678-556-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLES LANDING PRIMARY CARE SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "STUBBS",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "678-556-9460"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; 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.