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MIDDLE GEORGIA ALLERGY AND ASTHMA LLC NPI 1578951190


NPI Information

NPI: 1578951190
Provider Name: MIDDLE GEORGIA ALLERGY AND ASTHMA LLC
Classification: Allergy & Immunology - 207K00000X
Entity Type: Organization
Address:
229 INDUSTRIAL BLVD
DUBLIN, GA
ZIP 31021
Phone: (478) 353-1058
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MIDDLE GEORGIA ALLERGY AND ASTHMA LLC is an allergy immunology in Dublin, GA. The provider is an allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. MIDDLE GEORGIA ALLERGY AND ASTHMA LLC NPI is 1578951190. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

229 INDUSTRIAL BLVD
DUBLIN, GA
ZIP 31021-969
Phone: (478) 353-1058
Fax: (478) 238-0841

The provider's authorized official is Rodney Johnson .
The authorized official title is Physician and has the following contact phone number (478) 353-1058.

The enumeration date for this NPI number is 1/5/2015 and was last updated on 1/27/2021.


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
1207K00000XAllergy & Immunology64841GEORGIAYes

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
1202I032517OTHERGEORGIAMEDICARE PTAN
2003110844PMEDICAIDGEORGIA

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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