# PREMIERCARE OMEGA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premiercare Omega LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073140927
- **Authorized official:** DR. ROBERT CLYDE BOWMAN MD (PRESIDENT)
- **Authorized official phone:** (229) 387-4802

## Contact information

- **Practice address:** 130 MOORE ST, OMEGA, GA 31775-3075
- **Practice address phone:** (229) 528-6500
- **Practice address fax:** (229) 528-3283
- **Mailing address:** 130 MOORE ST, OMEGA, GA 31775-3075
- **Mailing address phone:** (229) 528-6500
- **Mailing address fax:** (229) 528-3283

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/23/2020
- **Last updated:** 05/05/2020