CLARKSTON FAMILY MEDICINE (NPI# 1588944771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588944771 |
| Entity Type | Organization |
| Organization Name | CLARKSTON FAMILY MEDICINE |
| Other Organization Name | CLARKSTON FAMILY MEDICAL CENTER |
| Practice Address |
3603 W Hill St Clarkston GA 30021-1207 |
| Practice Telephone | 4042997534 |
| Practice Fax Number | 4042990608 |
| Mailing Telephone | 4042997534 |
| Mailing Fax Number | 4042990608 |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2011-08-19 |
| Authorized Official Name | DR. MINBH THO HUYNH (SOLE PROPRIETOR) |
| Authorized Official Telephone | 4042997534 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | 019886 | GA | Managed Care Organizations |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 0085000391G | 05 |
| Other Name | Type Code |
|---|---|
| Clarkston Family medical center | Former Legal Business Name - Organization |
| Street Address |
3603 W HILL ST |
| City | CLARKSTON |
| State | GA |
| Zip Code | 30021-1207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144218082 | Minh-tho Huynh | Family Medicine | 3603 W Hill St, Clarkston, GA 30021-1207 | 2005-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578081808 | Marqueta A Coffer | Case Manager/Care Coordinator | 1380 Brockett Pl, Clarkston, GA 30021 | 2017-09-07 |
| 1063965143 | Bertukan Worku Demas | Pharmacist | 3671 Cobble Mill Ln, Clarkston, GA 30021 | 2016-07-26 |
| 1912341967 | Esther Kim | Family Medicine | 887 N Indian Creek Dr Ste A, Clarkston, GA 30021 | 2013-04-22 |
| 1265739437 | Carepoint Home Care, LLC | In Home Supportive Care | 4122 E Ponce Deleon Avenue, Unit 9, Clarkston, GA 30021 | 2011-02-23 |
| 1790956530 | Thu D. Vu | Dentist | 3596 Hill Street, Clarkston, GA 30021 | 2008-03-20 |
| 1740310630 | Gentle Dental | Dentist | 3595 Hill St., Clarkston, GA 30021 | 2007-03-07 |
| 1679528491 | Ojoru Osunkoya | Pediatrics | 4112 E. Ponce De Leon, Clarkston, GA 30021 | 2006-05-23 |
| 1700849825 | Regina Allen Hardin | Pediatrics | 4112 E. Ponce De Leon Avenue, Clarkston, GA 30021 | 2006-04-10 |
| 1831514538 | Caudelle & Wilson Eye Care LLC | Optometrist | 320 N Jeff Davis Drive, Suite A, Fayetteville, GA 30021 | 2014-03-04 |
| 1881865624 | Vanessa Phan | Dentist | 3596 Hill Street, Clarkston, GA 30021 | 2008-03-20 |
| Find all providers in zip 30021 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
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| 1033657143 | Glam She LLC | Point of Service | 4070 San Marco Way, Douglasville, GA 30135-2769 | 2017-02-09 |
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| 1245682079 | Butterfly Gardens Hopice & Palliative Care, LLC | Point of Service | 3112 Blackmon Ct, Hephzibah, GA 30815-7064 | 2016-07-05 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.