Fannin Physician Services LLC
Organization Active NPI Hospitalist Physician · Blue Ridge, GA
NPI 1972994499 · NPPES record last updated Jul 11, 2017
Key facts
- NPI
- 1972994499
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hospitalist Physician 208M00000X
- Legal business name
- FANNIN PHYSICIAN SERVICES LLC
- Practice address
- 2855 Old Highway 5
Blue Ridge, GA 30513-6248 - Phone
- (800) 893-9698
- NPI assigned
- Feb 6, 2015
- Organization subpart
- No
Authorized official
- Name
- Lisha C Falk
- Title
- VP of Contracting
- Phone
- (800) 893-9698
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician |
208M00000X | GA | Yes | |
| Physician Assistant |
363A00000X | GA | ||
| Nurse Practitioner |
363L00000X | GA |
Addresses
Primary practice location
2855 Old Highway 5
Blue Ridge, GA 30513-6248
Mailing address
200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003162205A | Medicaid | GA |
Other providers in Blue Ridge, GA
- Fannin County Board of Commissioners
- Fannin County Health Department
- Fannin Drugs, Inc
- Fannin Ed Physicians LLC
- Fannin Emergency Group LLC
- Fannin Regional Hospital Inc
- Fannin Regional Orthopaedic Center Inc
- Kristen Farist
- Herbert Eugene Flynn
- Fort Oglethorpe Emergency Physicians Group LLC
All providers in Blue Ridge, GA · Hospitalist Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.