HOMETOWN PHYSICIAN GROUP, LLC (NPI# 1992153548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992153548 |
| Entity Type | Organization |
| Organization Name | HOMETOWN PHYSICIAN GROUP, LLC |
| Other Organization Name | HOMETOWN FAMILY MEDICINE |
| Practice Address |
1698 Vernon Rd Lagrange GA 30240-4100 |
| Mailing Address |
300 Mooty Bridge Rd Suite 114 Lagrange GA 30240-1881 |
| Practice Telephone | 7062984937 |
| Mailing Telephone | 7065231699 |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-08-02 |
| Authorized Official Name | DR. CLARENCE TERRELL ALFORD JR. (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 7065941598 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 044619 | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Hometown Family Medicine | Doing Business As Name - Organization |
| Street Address |
1698 VERNON RD |
| City | LAGRANGE |
| State | GA |
| Zip Code | 30240-4100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598223844 | Urgencare, LLC | Clinic/Center | 2169 West Point Road, Suite 105, Lagrange, GA 30240 | 2019-03-06 |
| 1679075527 | Georgia Pain and Spine Care, Inc | Pain Medicine | 303 Smith St Fl 2, Lagrange, GA 30240 | 2018-03-07 |
| 1629463500 | Quoc Vinh Ngo | Emergency Medicine | Wellstar West Georgia Medical Center, 1504 Vernon Road, Lagrange, GA 30240 | 2015-03-30 |
| 1770913964 | Dell H Lawson | Counselor | 300 Medical Dr. Ste 705., Lagrange, GA 30240 | 2013-11-25 |
| 1629418793 | Mortar & Pestle, LLC | Pharmacy | 205 Vernon Street, Lagrange, GA 30240 | 2013-07-03 |
| 1336582329 | Weredeselam Menna Olango | Psychiatry & Neurology | 303 Medical Dr Ste 401, Lagrange, GA 30240 | 2013-04-10 |
| 1720333743 | Mortar and Pestle, LLC | Pharmacy | 300 Mooty Bridge Road, Lagrange, GA 30240 | 2012-07-16 |
| 1366768459 | Karin Taylor | Physical Medicine & Rehabilitation | 1600 Vernon Rd Ste A, Lagrange, GA 30240 | 2010-04-14 |
| 1871819458 | Kathryn J Hill | Counselor | 100 Smith St Ste 1, Lagrange, GA 30240 | 2010-04-08 |
| 1285802751 | Air Evac Ems, Inc. | Ambulance | 455 Aerotron Pkwy, Lagrange, GA 30240 | 2008-02-18 |
| Find all providers in zip 30240 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073834404 | Robert Ambrose Martin | Family Medicine | 380 S Davis Rd, Suite E&f, Lagrange, GA 30241-2588 | 2010-06-21 |
| 1821228255 | Olumide Adeniyl Ajayi | Family Medicine | 1497 Lafayette Pkwy, Lagrange, GA 30241-2552 | 2009-07-20 |
| 1124201249 | Lagrange Family Medicine | Family Medicine | 303 Medical Dr, Ste 406, Lagrange, GA 30240-4169 | 2007-12-12 |
| 1326181694 | Marcia D. Ebbs Md Psc | Family Medicine | 1009 New Moody Ln, Suite 4, Lagrange, KY 40031-9142 | 2007-02-15 |
| 1043318355 | Lagrange Med Center, LLC | Family Medicine | 309 Vernon St, Lagrange, GA 30240-3162 | 2006-09-20 |
| 1912932617 | Rhonda L Sharp | Family Medicine | 2600 N Detroit St, Lagrange, IN 46761-1154 | 2006-07-11 |
| 1750338968 | Srinivas R Bramhadevi | Family Medicine | 1497 Lafayette Street, Lagrange, GA 30241-2552 | 2006-05-31 |
| 1134184781 | Michael W Conway | Family Medicine | 207 N Townline Rd Ste 104, Lagrange, IN 46761 | 2006-04-18 |
| 1548220544 | Millard Reed Taylor | Family Medicine | 2120 N Detroit St, Lagrange, IN 46761 | 2006-03-24 |
| 1083607071 | Michael Lee Brackett | Family Medicine | 122a Gordon Commercial Dr, Lagrange, GA 30240-5740 | 2005-08-25 |
| Find all providers in LAGRANGE | ||||
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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.