Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Locust Grove Family Medicine

Organization Family Medicine Physician · NPI 1629169164

Locust Grove Family Medicine is a Family Medicine Physician in Locust Grove, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
Specialties on file
2

Practice location Address checks out

3778 Highway 42
Locust Grove, GA 30248-3632
Phone: (678) 610-6649
Fax: (678) 610-6025
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Non-Pharmacy Dispensing Site (primary) Taxonomy 332900000X · Licence 053715 (GA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 053715 (GA)

Record details

NPI number1629169164
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nimisha Trivedi — Owner · (678) 610-6649
NPI enumeratedSeptember 28, 2006
Last updated in NPPESMarch 14, 2016
Mailing address3778 Highway 42, Locust Grove, GA 30248-3632

Other providers in Locust Grove