National Provider Identifier Database

PHYSICIAN CONSULTANTS OF GEORGIA INTERVENTIONAL LLC
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

PHYSICIAN CONSULTANTS OF GEORGIA INTERVENTIONAL LLC
1445 GEORGIA AVE
SUITE 1
MACON, GA31201-7610
Phone: 478-250-1328
Fax:
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X
Ambulatory Surgical 261QA1903X
End-Stage Renal Disease (ESRD) Treatment 261QE0700X

* Indicates primary specialty

NPI Profile & details for PHYSICIAN CONSULTANTS OF GEORGIA INTERVENTIONAL LLC

NPI Number 1316389836
Legal business name
LBN
PHYSICIAN CONSULTANTS OF GEORGIA INTERVENTIONAL LLC
Authorized official REUBEN ELLIS - (PROPRIETOR)
Entity Organization
Organization subpart No
Enumeration date 07/25/2013
Last updated 11/19/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 055819
  • GA Medicaid: 003124971A

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for PHYSICIAN CONSULTANTS OF GEORGIA INTERVENTIONAL LLC

There are currently no reviews for PHYSICIAN CONSULTANTS OF GEORGIA INTERVENTIONAL LLC


NPIdb - Home
v2.201