# VAXCARE GEORGIA LLC

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

## Provider details

- **NPI number:** 1154620110
- **Authorized official:** CASEY DELOACH (PRESIDENT)
- **Authorized official phone:** (888) 829-8550

## Contact information

- **Practice address:** 989 GOVERNORS LN, SUITE 160, LEXINGTON, KY 40513-1173
- **Practice address phone:** (859) 514-5547
- **Practice address fax:** (859) 514-7084
- **Mailing address:** 4401 S ORANGE AVE, SUITE 117, ORLANDO, FL 32806-6946
- **Mailing address phone:** (888) 829-8550
- **Mailing address fax:** (888) 843-7191

## Taxonomy

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

## Other

- **Enumeration date:** 03/16/2011
- **Last updated:** 03/16/2011