| Warner Robins Outpatient | |
|
940 Ga Highway 96 Ste A Warner Robins GA 31088-2587 | |
| (478) 988-1002 | |
| (478) 988-8780 |
| Full Name | Warner Robins Outpatient |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 940 Ga Highway 96 Ste A, Warner Robins, Georgia |
| Authorized Official Name and Position | Margaret Jordan (RCM MANAGER) |
| Authorized Official Contact | 2298155454 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Warner Robins Outpatient 940 Ga Highway 96 Ste A Warner Robins GA 31088-2587 Ph: (478) 988-1002 | Warner Robins Outpatient 940 Ga Highway 96 Ste A Warner Robins GA 31088-2587 Ph: (478) 988-1002 |
| NPI Number | 1215934773 |
|---|---|
| Provider Enumeration Date | 06/30/2005 |
| Last Update Date | 12/15/2023 |
| Certification Date | 12/15/2023 |
| Medicare PECOS PAC ID | 8921089350 |
|---|---|
| Medicare Enrollment ID | O20040601000201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215934773 | NPI | - | NPPES |
| 000604502AI | Medicaid | GA | |
| 000450128G | Medicaid | GA | |
| 000604502A | Medicaid | GA | |
| 000604502AG | Medicaid | GA | |
| 000604502AJ | Medicaid | GA | |
| 000604502AP | Medicaid | GA | |
| 000604502P | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 582105225 (Georgia) | Primary |
| Provider Name | Jaymal R. Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962433599 PECOS PAC ID: 3779474010 Enrollment ID: I20040324000650 |
| Provider Name | Cynthia Q Mcwilliams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528043965 PECOS PAC ID: 3476638263 Enrollment ID: I20080304000267 |
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