Organization
COLISEUM HEALTH GROUP, LLC
Active
Other names
Coliseum Primary Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MASSEY (VP)
(478) 757-1500
Entity
Organization
Contact information
Practice address
3200 RIVERSIDE DR, MACON, GA 31210-2550
(478) 757-1500
Mailing address
3200 RIVERSIDE DR, MACON, GA 31210-2550
(478) 757-1500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/06/2006
Last updated
10/01/2007
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