Organization Active NPI

Middle Georgia Family Medicine,LLC

  • Family Medicine Physician
  • Eastman, GA
National Provider Identifier
1013184407
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MIDDLE GEORGIA FAMILY MEDICINE,LLC
Practice address
829 Plaza Ave
Eastman, GA 31023-6757
Phone
(478) 374-9309
Fax
(478) 374-3310
NPI assigned
May 14, 2008
Last updated
May 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Mike Hester
Title
Dodge County Hospital Cfo
Phone
(478) 448-4050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

829 Plaza Ave
Eastman, GA 31023-6757

Mailing address

829 Plaza Ave
Eastman, GA 31023-6757
Phone (478) 374-9309

Other names 1

  • Middle Georgia Family Medicine Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1013184407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 PLAZA AVE",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236757",
            "telephone_number": "478-374-9309",
            "fax_number": "478-374-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 PLAZA AVE",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236757",
            "telephone_number": "478-374-9309",
            "fax_number": "478-374-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE GEORGIA FAMILY MEDICINE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "HESTER",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "DODGE COUNTY HOSPITAL CFO",
        "authorized_official_telephone_number": "478-448-4050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middle Georgia Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eastman, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.