Provider Demographics
NPI:1568087021
Name:PRIMARY CARE & GERIATRICS ASSOCIATES OF CENTRAL GEORGIA, L.L.C
Entity Type:Organization
Organization Name:PRIMARY CARE & GERIATRICS ASSOCIATES OF CENTRAL GEORGIA, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROMMER
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAYAG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-929-2909
Mailing Address - Street 1:PO BOX 8537
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31095-8537
Mailing Address - Country:US
Mailing Address - Phone:478-923-2678
Mailing Address - Fax:478-929-4251
Practice Address - Street 1:1743 WATSON BLVD STE B
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3622
Practice Address - Country:US
Practice Address - Phone:478-929-2909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty