Fairmount Family Medicine PC

Organization Family Medicine Physician · NPI 1548559339

Fairmount Family Medicine PC provides Family Medicine Physician services in Fairmount, Georgia. Licensed in Georgia. Registered with an NPI since 2011.

Licensed in: GA
In the registry since: 2011
Specialties on file: 2

What do these letters mean?

PC — Professional corporation: A form of business registration, not a clinical qualification.

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Practice location Address checks out

2712 Highway 411 SE
Fairmount, GA 30139-3219 Not confirmed with CMS for 15 years — call before visiting
Phone: (706) 337-1930
Fax: (706) 337-1910

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary)	Taxonomy 363LF0000X · Licence RN107315 (GA)
Family Medicine Physician	Taxonomy 207Q00000X · Licence 32319 (GA)

Record details

NPI number	1548559339
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	Tony Sparks — President · (706) 337-1930
NPI enumerated	April 1, 2011
Last updated in NPPES	April 1, 2011
Mailing address	Po Box 703, Fairmount, GA 30139-0703