Coliseum Medical Group-Northside

LBN: Coliseum Primary Care Services, Llc
Coliseum Medical Group-Northside is an health care organization with primary practice located at 380 Hospital Dr Bldg A Suite 370, Macon GA 31217-8001. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Coliseum Primary Care Services, Llc can be contacted via phone (478) 474-4343, or through Turner, Kristine via phone (843) 856-7938.

Contact Information

Primary practice address
380 Hospital Dr Bldg A Suite 370 Macon GA 31217-8001
Phone: (478) 474-4343
Fax: (844) 664-2283
Website:
Map and Directions
Authorized official contact:
Name: Turner, Kristine
Phone: (843) 856-7938

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1629018023
LBN Legal business name Coliseum Primary Care Services, Llc
DBA Doing business as Coliseum Medical Group-Northside
Authorized official Turner, Kristine
Entity Organization
Organization subpart 1 No
Enumeration date Jun 7th, 2006
Last updated Nov 1st, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629018023 NPPES
Georgia Other DE1497 RAILROAD MEDICARE
Georgia MEDICAID 195942266A RAILROAD MEDICARE

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