Organization
GEORGIA PRIMARY CARE LLC
Active
Other names
Primary Clinic Senior Care, Primary Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY A MONTGOMERY NURSE PRACTITIONER (OWNER)
(918) 340-6477
Entity
Organization
Contact information
Practice address
866 ORANGE TER, MACON, GA 31201-2151
(478) 246-1114
(478) 202-2488
Mailing address
866 ORANGE TER, MACON, GA 31201-2151
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
02/19/2024
Last updated
06/24/2026
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