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NPI Code Detail

MEDICARE: MIDDLE GEORGIA MEDICAL ASSOCIATES, P.C.

MEDICARE: MIDDLE GEORGIA MEDICAL ASSOCIATES, 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
1207R00000XInternal Medicine Physician047262GA
2207R00000XInternal Medicine Physician022874GA
3207RP1001XPulmonary Disease Physician030052GA

General Provider Information

NPI Number : 1992751911
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDDLE GEORGIA MEDICAL ASSOCIATES, P.C.
Provider Business Mailing Address
First Line : 623 S HOUSTON LAKE RD
Second Line : SUITE 200
City : WARNER ROBINS
State : GA
Zip : 31088-9093
Country : US
Telephone Number : 478-923-6633
Fax Number : 478-923-8444
Provider Business Practice Location Address
First Line : 623 S HOUSTON LAKE RD
Second Line : SUITE 200
City : WARNER ROBINS
State : GA
Zip : 31088-9093
Country : US
Telephone Number : 478-923-6633
Fax Number : 478-923-8444
Authorized Official
Title or Position : PRACTICE ADMINISTRATOR
Name : SHARON CULPEPPER
Credential :
Telephone Number : 478-923-6633
Provider Enumeration Date : 05/25/2006
Last Update Date : 09/08/2010

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Directions to “MIDDLE GEORGIA MEDICAL ASSOCIATES, P.C. ” Practice Location

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