OrganizationNw Georgia Family PracticeFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address2526 Shallowford Road, Suite C, Marietta, GA 30066(770) 516-3500PECOS EnrollmentBased on the most recent information from CMS, provider Nw Georgia Family Practice does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1053405704Provider TypeOrganizationFull NameNw Georgia Family PracticeSubpartNoEnumeration Date10/3/2006Last Updated3/17/2008Contact InformationPractice LocationPractice Address2526 Shallowford Road, Suite C, Marietta, GA 30066Phone(770) 516-3500Fax(770) 516-3660Mailing LocationMailing Address2513 Shallowford Rd, Building 100, Marietta, GA 30066-6809Phone(770) 516-3500Fax(770) 516-3660Authorized OfficialNameZachery, Tamiko (Office Manager)Phone(770) 516-3500Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted Issuer