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Organization
CAPITAL CITY MEDICAL GROUP, L.L.C.
Active
Organization
CAPITAL CITY MEDICAL GROUP, L.L.C.
Active
Other names
Primary Care Plus
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER ALDEN KELLOGG (ASSOCIATE GENERAL COUNSEL)
(504) 681-8532
Entity
Organization
Contact information
Practice address
2645 ONEAL LN, BATON ROUGE, LA 70816-3179
(225) 926-7200
(225) 706-2182
Mailing address
3838 N CAUSEWAY BLVD, SUITE 2200, METAIRIE, LA 70002-8194
(504) 681-8259
(504) 681-8260
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207K00000X
Allergy & Immunology Physician
—
NULL
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
NULL
207RR0500X
Rheumatology Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Enumeration date
12/01/2010
Last updated
05/12/2014
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