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Organization

COLISEUM HEALTH GROUP, LLC

Active
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Organization

COLISEUM HEALTH GROUP, LLC

Active
Other names
Coliseum Primary Healthcare
Organization subpart
No

Provider details

NPI number
Authorized official
MICKEY PICKLER (VP)
(478) 841-2707
Entity
Organization

Contact information

Practice address
360 HOSPITAL DR, SUITE 110, MACON, GA 31217-3874
(478) 841-2707
Mailing address
360 HOSPITAL DR, SUITE 110, MACON, GA 31217-3874
(478) 841-2707

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
208000000X
Pediatrics Physician

Other

Enumeration date
06/07/2006
Last updated
04/20/2008
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