MEDICARE: ENDOCRINE CONSULTANTS, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	040452	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639224801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENDOCRINE CONSULTANTS, P.C.

Provider Business Mailing Address
First Line	:	2425 BROOKSTONE CENTRE PKWY
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-4501
Country	:	US
Telephone Number	:	706-322-1700
Fax Number	:	706-320-0456

Provider Business Practice Location Address
First Line	:	2425 BROOKSTONE CENTRE PKWY
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-4501
Country	:	US
Telephone Number	:	706-322-1700
Fax Number	:	706-320-0456

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MRS. GINA WANGLE
Credential	:
Telephone Number	:	706-322-1700

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	08/22/2020

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