Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Medipractic LLC

Organization Sports Medicine (Neuromusculoskeletal Medicine) Physician · NPI 1699834697

Medipractic LLC provides Sports Medicine (Neuromusculoskeletal Medicine) Physician services in Loganville, Georgia. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3955 Harrison Rd Ste 400
Loganville, GA 30052-8501 Not confirmed with CMS for 13 years — call before visiting
Phone: (770) 496-0326
Fax: (770) 492-9599
Show map & directions

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

Specialties & licences

Sports Medicine (Neuromusculoskeletal Medicine) Physician (primary) Taxonomy 204C00000X

Record details

NPI number1699834697
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Willis — Sec · (770) 496-0326
Other names Medipractic Pain Management
NPI enumeratedDecember 6, 2006
Last updated in NPPESDecember 21, 2012
Mailing address3955 Harrison Rd, Ste. 400, Loganville, GA 30052-8501