Healthcare Provider Details

I. General information

NPI: 1215852769
Provider Name (Legal Business Name): HEALTH SERVICES OF CENTRAL GEORGIA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 COLLEGE DR
BARNESVILLE GA
30204-1746
US

IV. Provider business mailing address

419 COLLEGE DR
BARNESVILLE GA
30204-1746
US

V. Phone/Fax

Practice location:
  • Phone: 678-359-5476
  • Fax:
Mailing address:
  • Phone: 678-359-5476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PHILIP WHEELER
Title or Position: CFO
Credential:
Phone: 706-509-3012