Organization
FIRST CHOICE PRIMARY CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE KENNEDY MCLEOD MSPH (CHIEF EXECUTIVE OFFICER)
(478) 787-4266
Entity
Organization
Contact information
Practice address
770 WALNUT ST, MACON, GA 31201-7307
(478) 787-4266
(478) 787-4199
Mailing address
PO BOX 4363, MACON, GA 31208-4363
(478) 787-4266
(478) 787-4199
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
713878795A
—
GA
Enumeration date
08/20/2007
Last updated
11/07/2012
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