Provider Demographics
NPI:1427353861
Name:SUWANEE PHYSICIANS, LLC
Entity type:Organization
Organization Name:SUWANEE PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMAHON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-889-4880
Mailing Address - Street 1:4905 WINDING ROSE DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-3074
Mailing Address - Country:US
Mailing Address - Phone:678-889-4880
Mailing Address - Fax:678-889-4881
Practice Address - Street 1:2151 PEACHFORD RD
Practice Address - Street 2:HOSPITALIST SERVICE
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6534
Practice Address - Country:US
Practice Address - Phone:770-313-2034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-16
Last Update Date:2011-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA45885207PE0004X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty