Colquitt Regional Anesthesia, LLC
Specialist in Moultrie, GA. Organization (NPI-2).
NPI number1154580512
StatusActive
Last updated in NPPESJun 2, 2008
Details
- NPI
- 1154580512
- Entity type
- Organization (NPI-2)
- Legal business name
- Colquitt Regional Anesthesia, LLC
- Organization subpart
- No
- Enumeration date
- Jun 2, 2008
- Last updated
- Jun 2, 2008
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
3131 S Main StMoultrie, GA 31768-6925
Phone 229-985-3420 · Fax 229-891-9079
Mailing address
Po Box 3305Moultrie, GA 31776-3305
Phone 229-985-3420 · Fax 229-891-9079
Authorized official
Judy B Ricks
Provider Enrollment Coordinator
2298919131
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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