| Progressive Medical Group, Llc | |
|
2131 Pace St Covington GA 30014-6652 | |
| (404) 966-0324 | |
| Not Available |
| Full Name | Progressive Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2131 Pace St, Covington, Georgia |
| Authorized Official Name and Position | Nicole E Ross (DIRECTOR/PHYSICIAN) |
| Authorized Official Contact | 4049660324 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Medical Group, Llc 2131 Pace St Covington GA 30014-6652 Ph: (404) 966-0324 | Progressive Medical Group, Llc 2131 Pace St Covington GA 30014-6652 Ph: (404) 966-0324 |
| NPI Number | 1427301811 |
|---|---|
| Provider Enumeration Date | 10/23/2012 |
| Last Update Date | 10/23/2012 |
| Medicare PECOS PAC ID | 9537312574 |
|---|---|
| Medicare Enrollment ID | O20121227000028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427301811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 43038 (Georgia) | Primary |
| Provider Name | Nicole E Ross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740204171 PECOS PAC ID: 0345244497 Enrollment ID: I20060905000205 |
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