Archbold Medical Group
Organization Active NPI Internal Medicine Physician · Cairo, GA
NPI 1265798185 · NPPES record last updated Jul 9, 2014
Key facts
- NPI
- 1265798185
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- ARCHBOLD MEDICAL GROUP
- Practice address
- 1090 5TH St SE
Cairo, GA 39828-3139 - Phone
- (229) 377-1100
- NPI assigned
- Apr 4, 2012
- Organization subpart
- No
Authorized official
- Name
- Charles D Hightower
- Title
- Senior VP/Cfo
- Phone
- (229) 228-2853
Other NPIs on the same Medicare enrollment 4
Corporate family (same tax ID) 13
Practitioners 10
-
Edward Christian Cameron, M.D.
-
Kristin F Deutsch, N.P.
-
Jason Townley Little, PA-C
-
Dale Wing, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081001000632 | GA | Part B Supplier - Clinic/Group Practice | 8123196383 |
Receives reassigned benefits from 103 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Thomasville, GA; Whigham, GA; Bainbridge, GA; Cairo, GA; Camilla, GA; Moultrie, GA; Pelham, GA; Quitman, GA |
National Provider Directory
- Tax ID family
- Archbold Medical Group Inc
Locations
100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141
900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
1090 5TH St SE
Cairo, GA 39828-3139
Mailing address
900 Cairo Rd
Thomasville, GA 31792-4255
Other names
- Cairo Internal Medicine
Other providers in Cairo, GA
- Adams Health Medical Supply LLC
- Christina Ellen Alicea
- Hope Almon
- Cherelle L Anderson
- Angels of Grace Community Wellness Center, Inc.
- Ronald Clinton Atwater Jr.
- Axis Chiropractic LLC
- Danielle Bach
- Megan Baggett
- Abdul Bari
All providers in Cairo, GA · Internal Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.