Legacy Physician Consultants, Llc is a medicare enrolled primary clinic (Internal Medicine) in Baldwin, Georgia. The current practice location for Legacy Physician Consultants, Llc is 209 Peach Orchard Rd, Baldwin, Georgia. For appointments, you can reach them via phone at
(706) 713-1904. The mailing address for Legacy Physician Consultants, Llc is 555 Forest Rd, Athens, Georgia and phone number is (706) 502-0503.
Legacy Physician Consultants, Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1508605668. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(706) 713-1904.
Primary Care Clinic Profile
| Full Name | Legacy Physician Consultants, Llc |
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| Speciality | Internal Medicine |
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| Location | 209 Peach Orchard Rd, Baldwin, Georgia |
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| Authorized Official Name and Position | Michael William Myers (COO) |
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| Authorized Official Contact | 7065020503 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Legacy Physician Consultants, Llc
555 Forest Rd
Athens
GA 30605-3823
Ph: (706) 502-0503 | Legacy Physician Consultants, Llc
209 Peach Orchard Rd
Baldwin
GA 30511-1803
Ph: (706) 713-1904 |
NPI Details:
| NPI Number | 1508605668 |
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| Provider Enumeration Date | 05/20/2024 |
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| Last Update Date | 05/20/2024 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 7911431457 |
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| Medicare Enrollment ID | O20241106003804 |
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Medical Identifiers
Medical identifiers for Legacy Physician Consultants, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1508605668 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Legacy Physician Consultants, Llc acts as a billing entity for following providers:
| Provider Name | Pramod Kakarala |
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| Provider Type | Practitioner - Internal Medicine |
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| Provider Identifiers | NPI Number: 1972881795
PECOS PAC ID: 0143473850
Enrollment ID: I20140930001782 |
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