| Optim Primary Care - Cobbtown | |
|
36671 Hwy 23 Cobbtown GA 30420-6042 | |
| (912) 557-1000 | |
| Not Available |
| Full Name | Optim Primary Care - Cobbtown |
|---|---|
| Speciality | Clinic/Center |
| Location | 36671 Hwy 23, Cobbtown, Georgia |
| Authorized Official Name and Position | Robert Guenthner (SECRETARY OF COMM.HOSP.HOLD.CO., LL) |
| Authorized Official Contact | 3126278427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optim Primary Care - Cobbtown 210 E Derenne Ave Savannah GA 31405-6736 Ph: (912) 644-5300 | Optim Primary Care - Cobbtown 36671 Hwy 23 Cobbtown GA 30420-6042 Ph: (912) 557-1000 |
| NPI Number | 1023253408 |
|---|---|
| Provider Enumeration Date | 12/12/2008 |
| Last Update Date | 07/27/2015 |
| Medicare PECOS PAC ID | 6204907124 |
|---|---|
| Medicare Enrollment ID | O20090621000003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023253408 | NPI | - | NPPES |
| 925639844B | Medicaid | GA | |
| 118512 | Other | MEDICARE PART A |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 038774 (Georgia) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Tattnall Medical Group-cobbtown Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 36671 Hwy. 23, Cobbtown, GA 30420 Phone: 912-684-3692 Fax: 912-684-3695 |