Milledgeville Familly Practice Center P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19830 Issued in GA

Legal business name

MILLEDGEVILLE FAMILLY PRACTICE CENTER P.C.

Practice address

540 W Thomas St Ste B
Milledgeville, GA 31061-2745

Phone

(478) 453-9435

Fax

(478) 453-9436

NPI assigned

Dec 18, 2007

Organization subpart

Yes

Parent organization

MILLEDGEVILLEAs reported in NPPES

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

Authorized official

Name

Dr. George W Grimes III, M.D.

Title

Doctor

Phone

(478) 453-9435

Specialties & licenses 2

Addresses

Other identifiers 1

Part of

Milledgeville Familly Practice Center PC

Locations

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1033393723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 W THOMAS ST STE B",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612745",
            "telephone_number": "478-453-9435",
            "fax_number": "478-453-9436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W THOMAS ST STE B",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612745",
            "telephone_number": "478-453-9435",
            "fax_number": "478-453-9436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLEDGEVILLE FAMILLY PRACTICE CENTER P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILLEDGEVILLE",
        "enumeration_date": "2007-12-18",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "GRIMES",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "478-453-9435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "19830",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "GA",
            "license": "19830",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00201517A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.