MEDICARE: MPPG, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Y00000X	Otolaryngology Physician
2	207YX0901X	Otology & Neurotology Physician
3	231H00000X	Audiologist

General Provider Information

NPI Number	:	1912065301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MPPG, INC.

Provider Business Mailing Address
First Line	:	PO BOX 931968
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-1968
Country	:	US
Telephone Number	:	912-350-5000
Fax Number	:	912-350-5123

Provider Business Practice Location Address
First Line	:	2429 HWY 17 SOUTH
Second Line	:
City	:	RICHMOND HILL
State	:	GA
Zip	:	31324
Country	:	US
Telephone Number	:	912-350-5000
Fax Number	:	912-350-5123

Authorized Official
Title or Position	:	PROVIDER ENROLLMENT COORDINATOR
Name	:	ROBIN J. MADDOX
Credential	:
Telephone Number	:	912-350-9335

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	09/11/2025

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Directions to “MPPG, INC. ” Practice Location

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