West Georgia Healthcare | |
210 South St Carrollton GA 30117-3738 | |
(770) 834-1898 | |
(770) 834-4814 |
Full Name | West Georgia Healthcare |
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Speciality | Family Medicine |
Location | 210 South St, Carrollton, Georgia |
Authorized Official Name and Position | Daniel Mielcarski (OWNER) |
Authorized Official Contact | 6784624402 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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West Georgia Healthcare 210 South St Carrollton GA 30117-3738 Ph: (770) 834-1898 | West Georgia Healthcare 210 South St Carrollton GA 30117-3738 Ph: (770) 834-1898 |
NPI Number | 1306319256 |
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Provider Enumeration Date | 01/03/2019 |
Last Update Date | 01/03/2019 |
Medicare PECOS PAC ID | 6608297064 |
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Medicare Enrollment ID | O20200611000255 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306319256 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
Provider Name | Chelsea R Hodge |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1205458098 PECOS PAC ID: 3678994043 Enrollment ID: I20200611000389 |
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