Provider Demographics
NPI:1033180625
Name:INTERNAL MEDICINE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/TRUSTEE
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:L
Authorized Official - Last Name:OGBURN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:478-745-1191
Mailing Address - Street 1:330 HOSPITAL DR
Mailing Address - Street 2:BLDG C, STE 200
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-3899
Mailing Address - Country:US
Mailing Address - Phone:478-745-1191
Mailing Address - Fax:478-750-4669
Practice Address - Street 1:330 HOSPITAL DR
Practice Address - Street 2:BLDG C, STE 200
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3899
Practice Address - Country:US
Practice Address - Phone:478-745-1191
Practice Address - Fax:478-750-4669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty