Medical Care Of Georgia, P.c. | |
50 Medical Ln Canton GA 30114-2417 | |
(770) 345-2300 | |
(770) 345-2330 |
Full Name | Medical Care Of Georgia, P.c. |
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Speciality | Clinic/Center |
Location | 50 Medical Ln, Canton, Georgia |
Authorized Official Name and Position | Alexander Tkeshelashvili Kessler (PRESIDENT) |
Authorized Official Contact | 7703452300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Medical Care Of Georgia, P.c. 50 Medical Ln Canton GA 30114-2417 Ph: (770) 345-2300 | Medical Care Of Georgia, P.c. 50 Medical Ln Canton GA 30114-2417 Ph: (770) 345-2300 |
NPI Number | 1124297163 |
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Provider Enumeration Date | 02/25/2008 |
Last Update Date | 11/16/2015 |
Medicare PECOS PAC ID | 8820167075 |
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Medicare Enrollment ID | O20080514000659 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124297163 | NPI | - | NPPES |
000958009B | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | 050647 (Georgia) | Secondary |
261QM2500X | Clinic/center - Medical Specialty | 050647 (Georgia) | Primary |
Provider Name | Alexander Kessler |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1518949528 PECOS PAC ID: 4385713536 Enrollment ID: I20080514000652 |
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