Organization
MEDICAL OUTREACH SERVICES OF MADISON PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL EDUARDO COSSIO MD (P)
(706) 342-9664
Entity
Organization
Contact information
Practice address
1075 S MAIN ST, SUITE 400, MADISON, GA 30650-2033
(706) 342-9664
Mailing address
1075 S MAIN ST, SUITE 400, MADISON, GA 30650-2033
(706) 342-9664
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000289517A
—
GA
Enumeration date
10/30/2015
Last updated
10/30/2015
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