| Millennium Physician Group Of Georgia Llc | |
|
610 19th St Columbus GA 31901-1528 | |
| (706) 322-7884 | |
| (833) 944-2043 |
| Full Name | Millennium Physician Group Of Georgia Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 610 19th St, Columbus, Georgia |
| Authorized Official Name and Position | Mary Haltigan (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Contact | 8778563774 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Millennium Physician Group Of Georgia Llc 2675 Winkler Ave Fl 2 Fort Myers FL 33901-9342 Ph: (877) 856-3774 | Millennium Physician Group Of Georgia Llc 610 19th St Columbus GA 31901-1528 Ph: (706) 322-7884 |
| NPI Number | 1538993084 |
|---|---|
| Provider Enumeration Date | 08/28/2024 |
| Last Update Date | 08/28/2024 |
| Medicare PECOS PAC ID | 9638699648 |
|---|---|
| Medicare Enrollment ID | O20250220003030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538993084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Curtis E Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538117528 PECOS PAC ID: 1456322544 Enrollment ID: I20040803000667 |
| Provider Name | John S Womble |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750379863 PECOS PAC ID: 2466418785 Enrollment ID: I20041208000125 |
| Provider Name | David M Celestial |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982691952 PECOS PAC ID: 8628025061 Enrollment ID: I20050407000168 |
| Provider Name | Donna E Burrell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891782066 PECOS PAC ID: 9032294491 Enrollment ID: I20080905000050 |
| Provider Name | James H Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699762666 PECOS PAC ID: 6406931864 Enrollment ID: I20081029000210 |
| Provider Name | Kamlesh G Ansingkar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184787327 PECOS PAC ID: 6608979554 Enrollment ID: I20100708000071 |
| Provider Name | Girija Das |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487762084 PECOS PAC ID: 7416071204 Enrollment ID: I20110126000698 |
| Provider Name | David A Theobald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588003859 PECOS PAC ID: 1850535691 Enrollment ID: I20130918000457 |
| Provider Name | Kanika R White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891134672 PECOS PAC ID: 7012144934 Enrollment ID: I20131220000106 |
| Provider Name | Autumn J Irions |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477097319 PECOS PAC ID: 9931473022 Enrollment ID: I20170928002110 |
| Provider Name | Timothy Wayne Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114586096 PECOS PAC ID: 1759714793 Enrollment ID: I20191205002724 |
| Provider Name | Joseph Tyler Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558998708 PECOS PAC ID: 9931527355 Enrollment ID: I20230817002586 |
| Provider Name | Makayla R Riles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134702699 PECOS PAC ID: 2961946512 Enrollment ID: I20240708000393 |
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