Provider Demographics
NPI:1083084966
Name:WELLCHECK LLC
Entity Type:Organization
Organization Name:WELLCHECK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-297-5687
Mailing Address - Street 1:1209 MARLOWE DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-3107
Mailing Address - Country:US
Mailing Address - Phone:478-297-5687
Mailing Address - Fax:478-254-5943
Practice Address - Street 1:1209 MARLOWE DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-3107
Practice Address - Country:US
Practice Address - Phone:478-297-5687
Practice Address - Fax:478-254-5943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA042424207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty