OrganizationActive
Community Primary Care of Georgia LLC
NPI 1336492511 · Geriatric Medicine (Family Medicine) Physician · Gray, GA
Provider details
- NPI number
- 1336492511
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Elize Joseph, Director of Practice Management(478) 621-2100
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1005 Boulder Dr
Gray, GA 31032-6141
Phone: (478) 621-2100
Fax: (478) 744-0481
Approximate (ZIP-level) locationGet directions
Mailing address
1005 Boulder Dr
Gray, GA 31032-6141
Additional practice locations (1)
- 4421 Carnes StAcworth, GA 30101-5305Phone: (478) 621-2072
Registry dates
- Enumerated
- 2012-10-25
- Last updated
- 2019-06-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.