Locust Grove Family Medicine
NPI #1629169164 in Locust Grove, Georgia
Provider Information
- NPI Number
- 1629169164
- Entity Type
- Organization
- Organization Name
- Locust Grove Family Medicine
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- Sep 28, 2006
- Last Updated
- Mar 14, 2016
Practice Location
- Address
- 3778 HIGHWAY 42
- City
- Locust Grove
- State
- Georgia
- ZIP Code
- 30248-3632
- Phone
- (678) 610-6649
Authorized Official
- Name
- DR. NIMISHA J TRIVEDI, MD
- Title
- OWNER
- Phone
- (678) 610-6649
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
| Non-Pharmacy Dispensing Site |
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