Organization
SOUTH GA GASTROENTEROLOGY & NUTRITION SUPPORT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA KAY COLE CPC-RMC (PRACTICE MANAGER)
(229) 985-1230
Entity
Organization
Contact information
Practice address
2509 S MAIN ST, MOULTRIE, GA 31768-6530
(229) 985-1230
(229) 985-1233
Mailing address
2509 S MAIN ST, MOULTRIE, GA 31768-6530
(229) 985-1230
(229) 985-1233
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
46662
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000810939B
—
GA
01
—
100012828
RAILROAD MEDICARE
GA
Enumeration date
12/14/2006
Last updated
01/04/2010
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