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

Phoenix Medical Office at College Park, LLC

Organization Internal Medicine Physician · NPI 1396033064

Phoenix Medical Office at College Park, LLC is an Internal Medicine Physician in College Park, 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

1631 Phoenix Blvd Ste 4
College Park, GA 30349-5545
Phone: (678) 788-8950
Fax: (678) 788-8953
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 39813 (GA)

Record details

NPI number1396033064
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kelvin Hamner — Owner/Md · (678) 788-8950
NPI enumeratedJuly 15, 2011
Last updated in NPPESDecember 11, 2012
Mailing address1631 Phoenix Blvd Ste 4, College Park, GA 30349-5545

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