| Wellpoint Medical Services, Pc | |
|
1533 Watson Blvd Ste B Warner Robins GA 31093-3449 | |
| (478) 328-6466 | |
| (478) 328-1338 |
| Full Name | Wellpoint Medical Services, Pc |
|---|---|
| Speciality | Clinic/center |
| Location | 1533 Watson Blvd, Warner Robins, Georgia |
| Authorized Official Name and Position | Anthony T Securo (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4783286466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellpoint Medical Services, Pc 1533 Watson Blvd Suite B Warner Robins GA 31093-3449 Ph: (478) 328-6466 | Wellpoint Medical Services, Pc 1533 Watson Blvd Ste B Warner Robins GA 31093-3449 Ph: (478) 328-6466 |
| NPI Number | 1114322575 |
|---|---|
| Provider Enumeration Date | 10/28/2014 |
| Last Update Date | 12/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114322575 | NPI | - | NPPES |
| 051736 | Other | GA | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 051736 (Georgia) | Primary |
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