Healthcare Provider Details

I. General information

NPI: 1790619583
Provider Name (Legal Business Name): ELITE PHYSICIANS GROUP, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 BROOKSTONE CENTRE PKWY
COLUMBUS GA
31904-9247
US

IV. Provider business mailing address

850 BROOKSTONE CENTRE PKWY
COLUMBUS GA
31904-9247
US

V. Phone/Fax

Practice location:
  • Phone: 706-507-5320
  • Fax: 706-507-4747
Mailing address:
  • Phone: 706-507-5320
  • Fax: 706-507-4747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2471M2300X
TaxonomyMammography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. PAIGE WHITE
Title or Position: CEO
Credential:
Phone: 706-457-4781