Organization
OCONEE HEALTHCARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARHAN SIDDIQUI M.D. (PHYSICIAN)
(478) 972-0277
Entity
Organization
Contact information
Practice address
133 COLAPARCHEE CT, MACON, GA 31210-7226
(478) 972-0277
(888) 326-5817
Mailing address
PO BOX 26698, MACON, GA 31221-6698
(404) 600-1215
(888) 326-5817
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RI0200X
Infectious Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000757831F
—
GA
Enumeration date
12/05/2006
Last updated
09/19/2019
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