Provider Demographics
NPI:1366293433
Name:CONCUR PRIMARY CARE LLC
Entity type:Organization
Organization Name:CONCUR PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:470-822-0101
Mailing Address - Street 1:11305 BELL RD STE 105
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-9504
Mailing Address - Country:US
Mailing Address - Phone:470-822-0101
Mailing Address - Fax:470-822-3701
Practice Address - Street 1:5395 JIMMY CARTER BLVD STE 500A
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-1502
Practice Address - Country:US
Practice Address - Phone:470-822-0101
Practice Address - Fax:470-822-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty