Organization
INFECTION SPECIALISTS OF MIDDLE GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MODUPE OLUWATOYIN OGUNSAKIN (OFFICE MANAGER)
(478) 922-5122
Entity
Organization
Contact information
Practice address
1420 WATSON BLVD, WARNER ROBINS, GA 31093-3446
(478) 922-5122
(478) 922-5221
Mailing address
1420 WATSON BLVD, WARNER ROBINS, GA 31093-3446
(478) 922-5122
(478) 922-5221
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
55136
GA
207RI0200X
Infectious Disease Physician
Primary
55136
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
721242214A
—
GA
Enumeration date
05/28/2009
Last updated
06/28/2024
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