Organization
PHYSICIAN CONSULTANTS OF GEORGIA INTERVENTIONAL LLC
Active
Other names
MIDTOWN VASCULAR CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REUBEN KRIS ELLIS M.D., FASN (PROPRIETOR)
(478) 250-1328
Entity
Organization
Contact information
Practice address
1445 GEORGIA AVE, SUITE 1, MACON, GA 31201-7610
(478) 250-1328
Mailing address
PO BOX 4461, MACON, GA 31208-4461
(478) 250-1328
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
055819
GA
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
055819
GA
261QM2500X
Medical Specialty Clinic/Center
Primary
055819
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003124971A
—
GA
Enumeration date
07/25/2013
Last updated
11/19/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us