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Organization

CAPITAL CITY MEDICAL GROUP, L.L.C.

Active
Other names
Primary Care Plus
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PETER ALDEN KELLOGG (ASSOCIATE GENERAL COUNSEL)
(504) 681-8532
Entity
Organization

Contact information

Practice address
2645 ONEAL LN, BATON ROUGE, LA 70816-3179
(225) 926-7200
(225) 706-2182
Mailing address
3838 N CAUSEWAY BLVD, SUITE 2200, METAIRIE, LA 70002-8194
(504) 681-8259
(504) 681-8260

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
207K00000X
Allergy & Immunology Physician
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
Primary
207RC0000X
Cardiovascular Disease Physician
207RR0500X
Rheumatology Physician
213ES0103X
Foot & Ankle Surgery Podiatrist

Other

Enumeration date
12/01/2010
Last updated
05/12/2014
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