| Coliseum Primary Care Services, Llc | |
|
380 Hospital Dr Bldg A Suite 370 Macon GA 31217-8001 | |
| (478) 474-4343 | |
| (844) 664-2283 |
| Full Name | Coliseum Primary Care Services, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 380 Hospital Dr, Macon, Georgia |
| Authorized Official Name and Position | Kristine Turner (CONTROLLER) |
| Authorized Official Contact | 8438567938 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coliseum Primary Care Services, Llc Po Box 403570 Atlanta GA 30384-3570 Ph: (478) 474-4343 | Coliseum Primary Care Services, Llc 380 Hospital Dr Bldg A Suite 370 Macon GA 31217-8001 Ph: (478) 474-4343 |
| NPI Number | 1629018023 |
|---|---|
| Provider Enumeration Date | 06/07/2006 |
| Last Update Date | 11/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629018023 | NPI | - | NPPES |
| DE1497 | Other | GA | RAILROAD MEDICARE |
| 195942266A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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