Omer L. Eubanks MD, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

008430 Issued in GA

Legal business name

OMER L. EUBANKS MD, PC

Practice address

1155 Hembree Rd
Suite 210
Roswell, GA 30076-4622

Phone

(770) 740-1753

Fax

(770) 740-8503

NPI assigned

Nov 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Omer L. Eubanks, M.D.

Title

President

Phone

(770) 740-1753

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• North Fulton Healthcare Associates Doing business as

Locations

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1982886248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 HEMBREE RD",
            "address_2": "SUITE 210",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764622",
            "telephone_number": "770-740-1753",
            "fax_number": "770-740-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 HEMBREE RD",
            "address_2": "SUITE 210",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764622",
            "telephone_number": "770-740-1753",
            "fax_number": "770-740-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMER L. EUBANKS MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "EUBANKS",
        "authorized_official_first_name": "OMER",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-740-1753",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "008430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA - RAILROAD MEDICARE",
            "identifier": "CL3877",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "432850",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300028185B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Fulton Healthcare Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shaun Olsen, DC
• Jennifer C Olson, SLP
• Isaac Oluwabunmi, RBT
• Kealy Olvera, DC
• Evie Oman, SLP
• Oncore PT, Inc
• One Stop Wellness, LLC
• Onpoint Medical Equipment LLC
• Amara Onuorah, PMHNP
• Chinwenwa Onwubiko

• Primary Care Clinic/Center in Roswell, GA
• Providers in Roswell, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; 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.