Provider Demographics
NPI:1710069083
Name:MCCABE MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:MCCABE MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MCCABE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-541-5373
Mailing Address - Street 1:307 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:GA
Mailing Address - Zip Code:30467-1832
Mailing Address - Country:US
Mailing Address - Phone:912-541-5373
Mailing Address - Fax:912-564-2524
Practice Address - Street 1:459 GA HIGHWAY 119 S
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:GA
Practice Address - Zip Code:31329-3021
Practice Address - Country:US
Practice Address - Phone:912-541-5373
Practice Address - Fax:912-564-2524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA036568207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty