Organization
WELLPOINT MEDICAL SERVICES, PC
Active
Other names
WellPoint Medical Services, PC
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY T SECURO M.D. (MEDICAL DIRECTOR)
(478) 328-6466
Entity
Organization
Contact information
Practice address
1533 WATSON BLVD, STE B, WARNER ROBINS, GA 31093-3449
(478) 328-6466
(478) 328-1338
Mailing address
1533 WATSON BLVD, SUITE B, WARNER ROBINS, GA 31093-3449
(478) 328-6466
(478) 328-1338
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
051736
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051736
MEDICARE
GA
Enumeration date
10/28/2014
Last updated
12/29/2014
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