# PHYSICIAN MANAGEMENT SERVICES OF EASTERN GEORGIA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VAXCARE CORPORATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780125294
- **Legal business name:** VAXCARE CORPORATION
- **Authorized official:** BRETT KENEFICK (PRESIDENT)
- **Authorized official phone:** (888) 829-8550

## Contact information

- **Practice address:** 410 PEACHTREE PKWY, SUITE 4260, CUMMING, GA 30041-7066
- **Practice address phone:** (888) 829-8550
- **Mailing address:** 800 N MAGNOLIA AVE STE 700, SUITE 250, ORLANDO, FL 32803-3264
- **Mailing address phone:** (888) 829-8550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 049380 | GA | Yes |

## Other

- **Enumeration date:** 03/16/2017
- **Last updated:** 07/24/2026