OrganizationPrimary Care Clinics Of GeorgiaFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1240 Jesse Jewell Pkwy SE, Suite 370, Gainesville, GA 30501-3862(770) 536-1004PECOS EnrollmentBased on the most recent information from CMS, provider Primary Care Clinics Of Georgia 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 5 days ago.Profile DetailsProvider ID1013961846Provider TypeOrganizationFull NamePrimary Care Clinics Of GeorgiaSubpartNoEnumeration Date5/19/2006Last Updated7/21/2008Contact InformationPractice LocationPractice Address1240 Jesse Jewell Pkwy SE, Suite 370, Gainesville, GA 30501-3862Phone(770) 536-1004Fax(770) 536-0905Mailing LocationMailing Address1240 Jesse Jewell Pkwy SE, Suite 370, Gainesville, GA 30501-3861Phone(770) 536-1004FaxUnlisted FaxAuthorized OfficialNameHocker, David Leon (Medical Director)Phone(770) 536-1004Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense041138GeorgiaProvider IdentifiersIDDescriptionIssuerID158736300DescriptionOtherIssuerUS DOL OWCPGeorgiaID1013961846DescriptionOtherIssuerBLUE CROSS AND BLUE SHIELGeorgiaID158736300DescriptionOtherIssuerHEALTHLINKGeorgiaIDP00089388DescriptionOtherIssuerMEDICARE RAILROADGeorgiaID000686463BDescriptionMedicaidIssuerUnlistedGeorgia