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Organization

MILLENNIUM INDEPENDENT PROVIDER NETWORK OF GEORGIA, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY HALTIGAN (DIRECTOR OF REVENUE CYCLE)
(877) 856-3774
Entity
Organization

Contact information

Practice address
610 19TH ST, COLUMBUS, GA 31901-1528
(706) 322-7884
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
(239) 599-2612

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
07/26/2024
Last updated
07/26/2024
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