Provider Demographics
NPI:1932283868
Name:CENTRAL GEORGIA INFECTIOUS DISEASES ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CENTRAL GEORGIA INFECTIOUS DISEASES ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:QUYEN
Authorized Official - Middle Name:N
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-741-5945
Mailing Address - Street 1:458 HEMLOCK ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-4200
Mailing Address - Country:US
Mailing Address - Phone:478-741-5945
Mailing Address - Fax:478-743-5890
Practice Address - Street 1:458 HEMLOCK ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-6886
Practice Address - Country:US
Practice Address - Phone:478-741-5945
Practice Address - Fax:478-743-5890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty