OrganizationActive
Clarkston Primary & Urgent Care, LLC
NPI 1043781420 · Family Medicine Physician · Clarkston, GA
Provider details
- NPI number
- 1043781420
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Etsubdenke Areaya, Authorized Official(678) 763-2247
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4600 E Ponce De Leon Ave Ste a
Clarkston, GA 30021-1839
Phone: (770) 703-5408
Fax: (877) 779-5837
Street-level locationGet directions
Mailing address
4600 E Ponce De Leon Ave Ste a
Clarkston, GA 30021-1839
Other names (DBA / former)
- Former legal business name
- Clarkston Primary & Urgent Care LLC
- Doing business as
- Clarkston Primary & Urgent Care LLC
Registry dates
- Enumerated
- 2018-12-11
- Last updated
- 2018-12-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.