Organization
LEGACY PHYSICIAN CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WILLIAM MYERS (COO)
(706) 502-0503
Entity
Organization
Contact information
Practice address
209 PEACH ORCHARD RD, BALDWIN, GA 30511-1803
(706) 713-1904
Mailing address
555 FOREST RD, ATHENS, GA 30605-3823
(706) 502-0503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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