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General NPI Number Information
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NPI Number | 1851947113
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Entity Type | Organization
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Legal Business Name | MIDDLE GEORGIA COMPLETE CARE LLC
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Dates
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Enumeration Date | 08/13/2019
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 504 OSIGIAN BLVD STE 2
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City | WARNER ROBINS
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State | GA
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Zip | 31088-8014
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Country | US
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Telephone | 478-213-7657
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Fax |
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Provider Business Mailing Address
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Address Line | 1114 GA HIGHWAY 96 STE C-1 #243
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City | KATHLEEN
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State | GA
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Zip | 31047
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK NARTEY NARH-MARTEY
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Credential | MD
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Telephone | 614-446-3072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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