| Organization Name: | COMPREHENSIVE CARE MEDICAL L.L.C |
| NPI Number: | 1831313683 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANA Y PAINE (OFFICE MANAGER) |
| Mailing Address: | 4052 Atlanta St Suite C Powder Springs |
| State: | GA US |
| Postal Code: | 301272693 |
| Phone Number: | 7704390198 |
| Fax Number: | 7704390297 |
| NPI Enumeration Date: | 04/12/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 016356 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |