Utm of Georgia Physicians LLC
NPI 1255893038ActiveOrganization· Family Medicine· Fort Oglethorpe, GA
Family Medicine in Fort Oglethorpe, Georgia, registered in NPPES in April 2019. The authorized official on file is Rudy Blank, Cfo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1255893038 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 2, 2019 |
| Last updated in NPPES | May 5, 2023 |
| Certified by provider | May 5, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Clinic/Center | 261Q00000X | — | — |
| Clinic/Center, Urgent Care | 261QU0200X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA) |
|---|
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