Provider Demographics
NPI:1710382320
Name:CENTRAL GEORGIA HEART CENTER, PC
Entity type:Organization
Organization Name:CENTRAL GEORGIA HEART CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-741-1208
Mailing Address - Street 1:1062 FORSYTH ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-8638
Mailing Address - Country:US
Mailing Address - Phone:478-741-1208
Mailing Address - Fax:478-741-9361
Practice Address - Street 1:1062 FORSYTH ST STE 1B
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-8638
Practice Address - Country:US
Practice Address - Phone:478-621-7501
Practice Address - Fax:478-621-7505
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL GEORGIA HEART CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-24
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty