Organization
PHYSICIAN CONSULTANTS OF GEORGIA DUBLIN
Active
Other names
Dublin Vascular Center
Organization subpart
No
Provider details
NPI number
Authorized official
REUBEN K. ELLIS MD (CEO/OWNER)
(478) 353-3044
Entity
Organization
Contact information
Practice address
207 INDUSTRIAL BLVD, DUBLIN, GA 31021-2903
(478) 353-3044
Mailing address
PO BOX 13654, MACON, GA 31208-3654
(478) 353-3044
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
55819
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180550000053643
—
GA
Enumeration date
04/03/2018
Last updated
04/03/2018
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