MEDICARE: FIRST CHOICE PRIMARY CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)	26859	GA

General Provider Information

NPI Number	:	1023492162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CHOICE PRIMARY CARE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 4363
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31208-4363
Country	:	US
Telephone Number	:	478-787-4266
Fax Number	:

Provider Business Practice Location Address
First Line	:	2460 SHURLING DR
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31211-2525
Country	:	US
Telephone Number	:	478-787-4266
Fax Number	:	478-787-4199

Authorized Official
Title or Position	:	CEO
Name	:	KATHERINE MCLEOD
Credential	:
Telephone Number	:	478-787-4266

Provider Enumeration Date	:	07/18/2015
Last Update Date	:	01/05/2026

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