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Contact Information

PEDIATRIC PULMONOLOGY OF CENTRAL GA
1062 FORSYTH ST
SUITE 2 C
MACON, GA31201-8637
 Phone: 478-755-0036
 Fax: 478-755-1254
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Pulmonology

2080P0214X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PEDIATRIC PULMONOLOGY OF CENTRAL GA

NPI Number 1629356670
LBN Legal business name PEDIATRIC PULMONOLOGY OF CENTRAL GA
Authorized official TAMMY COBB - (BILLING MGR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/25/2011
Last updated 03/20/2012 - About 14 years ago
Identifiers
GA Medicaid 000670535J
Other 319745 WELLCARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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