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General NPI Number Information
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NPI Number | 1295903490
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Entity Type | Organization
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Legal Business Name | HEART OF GEORGIA SLEEP MEDICINE, LLC
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 1006 HILLCREST PKWY STE 1
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City | DUBLIN
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State | GA
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Zip | 31021-4259
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Country | US
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Telephone | 478-272-4544
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Fax | 478-275-1306
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Provider Business Mailing Address
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Address Line | PO BOX 4525
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City | MACON
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State | GA
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Zip | 31208-4525
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Country | US
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Telephone | 478-272-4544
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Fax | 478-275-1306
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Authorized Official
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Title or Position | OWNER
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Name | MRS. PAMELA A NOLES
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Credential | RPSGT
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Telephone | 478-272-4544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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