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Organization

CAPITAL CITY MEDICAL GROUP, LLC

Active
Other names
Primary Care Plus
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PETER ALDEN KELLOGG (ASSOCIATE GENERAL COUNSEL)
(504) 681-8532
Entity
Organization

Contact information

Practice address
120 MEADOWCREST ST, SUITE 120, GRETNA, LA 70056-5255
(504) 620-5661
(504) 620-5674
Mailing address
3838 N CAUSEWAY BLVD, SUITE 2200, METAIRIE, LA 70002-8194
(504) 681-8259
(504) 681-8260

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
207RR0500X
Rheumatology Physician
213ES0103X
Foot & Ankle Surgery Podiatrist

Other

Enumeration date
11/20/2013
Last updated
05/12/2014
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