Miguel E. Cossio M.D., P.C.

Organization Active NPI Internal Medicine Physician · Madison, GA

NPI 1871545673 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1871545673
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
License
025337 (GA)
Legal business name
MIGUEL E. COSSIO M.D., P.C.
Practice address
1075 S Main St
Madison, GA 30650-2033
Phone
(706) 342-9664
NPI assigned
May 17, 2006
Organization subpart
No

Authorized official

Name
Miguel E. Cossio, M.D.
Title
Owner
Phone
(706) 342-9664

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20060104000060 GA Part B Supplier - Clinic/Group Practice 4981626058 Receives reassigned benefits from 1 practitioner
Practice locations: Madison, GA

National Provider Directory

Locations

1075 S Main St
Madison, GA 30650
Phone (706) 342-3103

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DHCEAD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207R00000X 025337 GA Yes

Addresses

Primary practice location

1075 S Main St
Madison, GA 30650-2033

Mailing address

1075 S Main St
Madison, GA 30650-2033
Phone (706) 342-9664

Other providers in Madison, GA

All providers in Madison, GA · Internal Medicine Physician in Georgia

Sources for this page

Verify at the official NPI Registry.