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NEOCARE OF CENTRAL GEORGIA PC NPI 1053627703


NPI Information

NPI: 1053627703
Provider Name: NEOCARE OF CENTRAL GEORGIA, PC

Doing Business As: FAMILY CARE OF MIDDLE GEORGIA

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 11D0994177

Address:
3203 VINEVILLE AVE
MACON, GA
ZIP 31204
Phone: (478) 471-0273
Get Directions

NEOCARE OF CENTRAL GEORGIA, PC is a family medicine in Macon, GA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. NEOCARE OF CENTRAL GEORGIA, PC NPI is 1053627703. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Family Care Of Middle Georgia.

The provider's business location address is:

3203 VINEVILLE AVE
MACON, GA
ZIP 31204-323
Phone: (478) 471-0273
Fax: (478) 471-1471

The provider's authorized official is Irene Ho .
The authorized official title is Office Manager and has the following contact phone number (478) 471-0273.

The CLIA number assigned to this NPI record is 11D0994177 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/19/2010 and was last updated on 3/17/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine076861GEORGIAYes
2208000000XPediatricsNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000262996HMEDICAIDGEORGIA
2003177670AMEDICAIDGEORGIA
3000262996IMEDICAIDGEORGIA
4003171965EMEDICAIDGEORGIA
5003171965FMEDICAIDGEORGIA
6000053347CMEDICAIDGEORGIA
7003171965DMEDICAIDGEORGIA
8000053347DMEDICAIDGEORGIA
9003177670CMEDICAIDGEORGIA
10000053347EMEDICAIDGEORGIA
11003121342GMEDICAIDGEORGIA
12003177670BMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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