| Rome Gi | |
|
11 John Maddox Dr Nw Rome GA 30165-1413 | |
| (706) 295-3992 | |
| (706) 378-5582 |
| Full Name | Rome Gi |
|---|---|
| Speciality | Internal Medicine |
| Location | 11 John Maddox Dr Nw, Rome, Georgia |
| Authorized Official Name and Position | Keith Baldwin (ADMINISTRATOR) |
| Authorized Official Contact | 7062923036 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rome Gi 11 John Maddox Dr Nw Rome GA 30165-1413 Ph: (706) 295-3992 | Rome Gi 11 John Maddox Dr Nw Rome GA 30165-1413 Ph: (706) 295-3992 |
| NPI Number | 1356309314 |
|---|---|
| Provider Enumeration Date | 05/01/2006 |
| Last Update Date | 05/06/2014 |
| Medicare PECOS PAC ID | 4981518594 |
|---|---|
| Medicare Enrollment ID | O20031118000560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356309314 | NPI | - | NPPES |
| 300035104A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Louis Edward Lataif |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184688798 PECOS PAC ID: 4688588106 Enrollment ID: I20110128000780 |
| Provider Name | Adedamola Lufadeju |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1982816369 PECOS PAC ID: 4587719257 Enrollment ID: I20110413001024 |
| Provider Name | Kenneth Obi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184853053 PECOS PAC ID: 3274795489 Enrollment ID: I20160328000706 |
| Provider Name | Kelli Strickland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831750926 PECOS PAC ID: 7810323383 Enrollment ID: I20200130003321 |
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