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Contact Information

PRIMARY PEDIATRICS, PC
5300 BOWMAN RD
MACON, GA31210
 Phone: 478-741-3007
 Fax: 478-200-1960
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for PRIMARY PEDIATRICS, PC

NPI Number 1477638575
LBN Legal business name PRIMARY PEDIATRICS, PC
Authorized official LANCE SLADE - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/26/2006
Last updated 04/09/2025 - More than a year ago
Identifiers
GA Medicaid 003216177A
GA Medicaid 300034047A
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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