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MIDSTATE FAMILY MEDICINE PC NPI 1528186913


NPI Information

NPI: 1528186913
Provider Name: MIDSTATE FAMILY MEDICINE, PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
2191 INGLESIDE AVE
MACON, GA
ZIP 31204
Phone: (478) 745-0095
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MIDSTATE FAMILY MEDICINE, 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. MIDSTATE FAMILY MEDICINE, PC NPI is 1528186913. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2191 INGLESIDE AVE
MACON, GA
ZIP 31204-029
Phone: (478) 745-0095
Fax: (478) 745-8138

The provider's authorized official is Carol N Pryby .
The authorized official title is President and has the following contact phone number (478) 745-0095.

The enumeration date for this NPI number is 3/26/2007 and was last updated on 10/18/2009.


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 Medicine46215GEORGIAYes

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
1GRP6830MEDICARE ID-TYPE UNSPECIFIEDGEORGIAMEDICARE-GRP

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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