| Correctiona Medical Associates | |
|
205 Mcintosh Place Dr Fayetteville GA 30214-7384 | |
| (770) 719-3319 | |
| Not Available |
| Full Name | Correctiona Medical Associates |
|---|---|
| Speciality | Clinic/center |
| Location | 205 Mcintosh Place Dr, Fayetteville, Georgia |
| Authorized Official Name and Position | Marcus Moseley (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 4048532097 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Correctiona Medical Associates 205 Mcintosh Place Dr Fayetteville GA 30214-7384 Ph: (770) 719-3319 | Correctiona Medical Associates 205 Mcintosh Place Dr Fayetteville GA 30214-7384 Ph: (770) 719-3319 |
| NPI Number | 1407017965 |
|---|---|
| Provider Enumeration Date | 06/18/2008 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407017965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | RN113001 (Georgia) | Primary |
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