| Mccaysville Internal Medicine Llc | |
|
6 Elm St Blue Ridge GA 30513-2906 | |
| (706) 492-4294 | |
| (706) 492-4226 |
| Full Name | Mccaysville Internal Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6 Elm St, Blue Ridge, Georgia |
| Authorized Official Name and Position | Ronald Timothy Jabaley Ii (PRESIDENT) |
| Authorized Official Contact | 7064924226 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mccaysville Internal Medicine Llc Po Box 1058 Mc Caysville GA 30555-1058 Ph: (706) 492-4294 | Mccaysville Internal Medicine Llc 6 Elm St Blue Ridge GA 30513-2906 Ph: (706) 492-4294 |
| NPI Number | 1477574473 |
|---|---|
| Provider Enumeration Date | 07/22/2006 |
| Last Update Date | 04/15/2015 |
| Medicare PECOS PAC ID | 7012962160 |
|---|---|
| Medicare Enrollment ID | O20050322000376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477574473 | NPI | - | NPPES |
| DG1562 | Other | RAILROAD MEDICARE | |
| 3709117 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ronald T Jabaley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558344994 PECOS PAC ID: 4486547957 Enrollment ID: I20050329000021 |
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