| The Neurological Center Of East Georgia Pc | |
|
1601 Fair Road Suite 400 Cotton Ridge Medical Plaza Statesboro GA 30458-1699 | |
| (912) 871-8900 | |
| (912) 871-8901 |
| Full Name | The Neurological Center Of East Georgia Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1601 Fair Road, Statesboro, Georgia |
| Authorized Official Name and Position | Gina Michele Taormina (ADMINISTRATOR) |
| Authorized Official Contact | 9128718900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Neurological Center Of East Georgia Pc 1601 Fair Road Suite 400 Statesboro GA 30458-1699 Ph: (912) 871-8900 | The Neurological Center Of East Georgia Pc 1601 Fair Road Suite 400 Cotton Ridge Medical Plaza Statesboro GA 30458-1699 Ph: (912) 871-8900 |
| NPI Number | 1184737728 |
|---|---|
| Provider Enumeration Date | 08/17/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7618903832 |
|---|---|
| Medicare Enrollment ID | O20050711000477 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184737728 | NPI | - | NPPES |
| GPA675 | Other | SC | MEDICAID |
| 52676473001 | Other | GA | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 040258 (Georgia) | Primary |
| Provider Name | Michael A Taormina |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629257787 PECOS PAC ID: 1456387489 Enrollment ID: I20110816000130 |
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