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COLISEUM HEALTH GROUP LLC NPI 1912947367


NPI Information

NPI: 1912947367
Provider Name: COLISEUM HEALTH GROUP, LLC

Doing Business As: COLISEUM PRIMARY HEALTHCARE

Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
360 HOSPITAL DR
SUITE 110
MACON, GA
ZIP 31217
Phone: (478) 841-2707
Get Directions

COLISEUM HEALTH GROUP, LLC is an internal medicine in Macon, GA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. COLISEUM HEALTH GROUP, LLC NPI is 1912947367. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Coliseum Primary Healthcare.

The provider's business location address is:

360 HOSPITAL DR
SUITE 110
MACON, GA
ZIP 31217-874
Phone: (478) 841-2707

The provider's authorized official is Mickey Pickler .
The authorized official title is Vp and has the following contact phone number (478) 841-2707.

The enumeration date for this NPI number is 6/7/2006 and was last updated on 4/20/2008.


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
1208000000XPediatricsNo
2207R00000XInternal MedicineYes

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
1GRP5184MEDICARE ID-TYPE UNSPECIFIEDGEORGIACAHABA MEDICARE/ GA MEDIC
2=========OTHERGEORGIACHAMPUS TRICARE PROGRAM
3DA9580MEDICARE ID-TYPE UNSPECIFIEDGEORGIARAILROAD MEDICARE

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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