# MEDICAL COLLEGE OF GEORGIA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114138849
- **Authorized official:** MR. DAVID BUTTS HSA (HEALTH SERVICE ADMINISTRATOR)
- **Authorized official phone:** (706) 444-1052

## Contact information

- **Practice address:** PRISON RD, SPARTA, GA 31081
- **Practice address phone:** (706) 444-1052
- **Mailing address:** PO BOX 224, MILLEDGEVILLE, GA 31059-0224
- **Mailing address phone:** (706) 444-1050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2400X | Prison Health Clinic/Center | 050206 | GA | Yes |

## Other

- **Enumeration date:** 05/24/2007
- **Last updated:** 08/22/2020