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General NPI Number Information
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NPI Number | 1215182977
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Entity Type | Organization
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Legal Business Name | UNLIMITED MEDICAL SOLUTIONS, INC.
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Dates
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Enumeration Date | 11/22/2008
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Last Update Date | 11/22/2008
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Provider Practice Location Address
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Address Line | 3200 RIVERSIDE DR BLDG B
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City | MACON
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State | GA
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Zip | 31210-2550
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Country | US
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Telephone | 404-207-6294
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4355
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City | MARIETTA
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State | GA
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Zip | 30061-4355
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Country | US
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Telephone | 404-207-6294
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THEOPHOLIEUS SAMUEL WORRELL SR.
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Credential | M.D.
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Telephone | 404-207-6294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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