| Inpatient Consultants Of Georgia, Inc | |
|
777 Hemlock St Macon GA 31201-2102 | |
| (314) 317-0600 | |
| (314) 317-0606 |
| Full Name | Inpatient Consultants Of Georgia, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 777 Hemlock St, Macon, Georgia |
| Authorized Official Name and Position | Bruce Gipe (PRESIDENT) |
| Authorized Official Contact | 8656931000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inpatient Consultants Of Georgia, Inc 1643 Nw 136th Ave Ste 100 Sunrise FL 33323-2857 Ph: (800) 424-3672 | Inpatient Consultants Of Georgia, Inc 777 Hemlock St Macon GA 31201-2102 Ph: (314) 317-0600 |
| NPI Number | 1659403970 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 11/12/2020 |
| Medicare PECOS PAC ID | 2264539618 |
|---|---|
| Medicare Enrollment ID | O20070518000143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659403970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208M00000X | Hospitalist | (* (Not Available)) | Secondary |
| Provider Name | Nicola P Revills |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124280268 PECOS PAC ID: 3577734045 Enrollment ID: I20110914000558 |
| Provider Name | Lynn Petras |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710059340 PECOS PAC ID: 6305096637 Enrollment ID: I20160310001038 |
| Provider Name | Chlin Tennyson-yemm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629713375 PECOS PAC ID: 8325425762 Enrollment ID: I20240528001916 |
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