Organization
MADISON PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY B GIBSON MD (CEO)
(706) 342-3103
Entity
Organization
Contact information
Practice address
1820 BETHANY RD, MADISON, GA 30650-4701
(706) 342-3103
(706) 342-7430
Mailing address
1820 BETHANY RD, MADISON, GA 30650-4701
(706) 342-3103
(706) 342-7430
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
015584
GA
Other
Enumeration date
07/10/2006
Last updated
08/10/2007
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