Organization
FASTTRACK IMMEDIATE CARE OF MILLEDGEVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE NOBLES PAULK (CEO)
(478) 271-0337
Entity
Organization
Contact information
Practice address
1909 N COLUMBIA ST, MILLEDGEVILLE, GA 31061-2170
(478) 295-3000
(478) 295-3003
Mailing address
126 N 2ND ST, COCHRAN, GA 31014-6330
(478) 271-0337
(478) 295-3003
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/28/2014
Last updated
07/21/2022
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