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

Old National Primary Care Clinic, LLC

Organization Internal Medicine Physician · NPI 1376829028

Old National Primary Care Clinic, LLC is an Internal Medicine Physician in Atlanta, Georgia. Licensed in Georgia. Registered with an NPI since 2011.

Licensed in
GA
In the registry since
2011
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

5185 Old National Hwy
Atlanta, GA 30349-3244
Phone: (404) 763-9300
Fax: (404) 763-9306
Show map & directions

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

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 066254 (GA)

Record details

NPI number1376829028
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Eva Beaulieu — Owner · (786) 556-0495
NPI enumeratedOctober 26, 2011
Last updated in NPPESMay 10, 2013
Mailing address1065 Jodeco Rd, Stockbridge, GA 30281-4953

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