# GEORGIA COLLEGE & STATE UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GCSU Sports Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154758001
- **Authorized official:** DR. PAUL JONES MD (VP OF ADMINISTRATION & OPERATIONS)
- **Authorized official phone:** (478) 445-5148

## Contact information

- **Practice address:** 120 W CAMPUS DR CBX 091, MILLEDGEVILLE, GA 31061-1990
- **Practice address phone:** (478) 445-5288
- **Practice address fax:** (478) 445-3142
- **Mailing address:** 120 W CAMPUS DR CBX 091, MILLEDGEVILLE, GA 31061-1990
- **Mailing address phone:** (478) 445-5288
- **Mailing address fax:** (478) 445-3142

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/08/2013
- **Last updated:** 10/08/2013