| Miller Family Practice, Llc. | |
|
1818 Forsyth Street Suite 200 Macon GA 31201-1636 | |
| (478) 745-7878 | |
| (478) 745-1636 |
| Full Name | Miller Family Practice, Llc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1818 Forsyth Street, Macon, Georgia |
| Authorized Official Name and Position | Conrad N. Miller (PRESIDENT) |
| Authorized Official Contact | 4787457878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miller Family Practice, Llc. P.o. Box 28170 Macon GA 31221-8170 Ph: (478) 254-5943 | Miller Family Practice, Llc. 1818 Forsyth Street Suite 200 Macon GA 31201-1636 Ph: (478) 745-7878 |
| NPI Number | 1073723680 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 0840241634 |
|---|---|
| Medicare Enrollment ID | O20050209000630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073723680 | NPI | - | NPPES |
| DC7439 | Other | GA | MEDICARE RAILROAD |
| 000684615G | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 040962 (Georgia) | Primary |
| 208D00000X | General Practice | GA 040963 (Georgia) | Secondary |
| Provider Name | Conrad N Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629149430 PECOS PAC ID: 5890746697 Enrollment ID: I20050211000184 |
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