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Vistas Medical Center,pc
Medical Specialty Clinic/Center in Stone Mountain, N/A
NPI 1104064815

Vistas Medical Center,pc is a Medical Specialty Clinic/Center based in Stone Mountain, and is specialized in Medical Specialty. Vistas Medical Center,pc practices in Stone Mountain, . The NPI Number for Vistas Medical Center,pc is 1104064815 and holds a License No. GA038149 (N/A).

The current practice location address for Vistas Medical Center,pc is 5329 Memorial Dr Ste A, Stone Mountain, and can be reached out via phone at 404-296-7695 and via fax at 404-296-7696.

Location: 5329 Memorial Dr Ste A, Stone Mountain, , 30087-0027
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104064815
Provider Name
Vistas Medical Center,pc
Credential
Provider Entity Type
Organization
Address
5329 Memorial Dr Ste A, Stone Mountain, , 30087-0027
Phone Number
404-296-7695
Fax Number
404-296-7696
Provider Enumeration Date
02/03/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000727108D 05 GA
321313 01 GA WELLCARE
institution
Provider Business Practice Location Address Details
Address
5329 Memorial Dr Ste A
City
Stone Mountain
State
Zip
30083
Phone Number
404-296-7695
Fax Number
404-296-7696
person
Provider Business Mailing Address Details
Address
5329 Memorial Dr Ste A
City
Stone Mountain
State
Zip
30083
Phone Number
404-296-7695
Fax Number
404-296-7696
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
GA038149 (Georgia)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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