# CAPITAL CITY MEDICAL GROUP, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Primary Care Plus
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144522855
- **Authorized official:** MR. PETER ALDEN KELLOGG (ASSOCIATE GENERAL COUNSEL)
- **Authorized official phone:** (504) 681-8532

## Contact information

- **Practice address:** 2645 ONEAL LN, BATON ROUGE, LA 70816-3179
- **Practice address phone:** (225) 926-7200
- **Practice address fax:** (225) 706-2182
- **Mailing address:** 3838 N CAUSEWAY BLVD, SUITE 2200, METAIRIE, LA 70002-8194
- **Mailing address phone:** (504) 681-8259
- **Mailing address fax:** (504) 681-8260

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 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