# FASTTRACK IMMEDIATE CARE OF MILLEDGEVILLE LLC

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

## Provider details

- **NPI number:** 1366847790
- **Authorized official:** NICOLE NOBLES PAULK (CEO)
- **Authorized official phone:** (478) 271-0337

## Contact information

- **Practice address:** 1909 N COLUMBIA ST, MILLEDGEVILLE, GA 31061-2170
- **Practice address phone:** (478) 295-3000
- **Practice address fax:** (478) 295-3003
- **Mailing address:** 126 N 2ND ST, COCHRAN, GA 31014-6330
- **Mailing address phone:** (478) 271-0337
- **Mailing address fax:** (478) 295-3003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/28/2014
- **Last updated:** 07/21/2022