| Southern Chiropractic Of Douglas | |
|
506 Ashley St W, Douglas, GA 31533-2308 | |
| (912) 389-0042 | |
| Not Available |
| Full Name | Southern Chiropractic Of Douglas |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 506 Ashley St W, Douglas, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538679394 | NPI | - | NPPES |
| CHIR008807 | Other | GA | PROFESSIONAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CHIR008807 (Georgia) | Primary |
| Provider Name | Joshua B Mizell |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1417249343 PECOS PAC ID: 7618140005 Enrollment ID: I20111031000529 |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Chiropractic Of Douglas 506 Ashley St W, Douglas, GA 31533-2308 Ph: (912) 389-0042 | Southern Chiropractic Of Douglas 506 Ashley St W, Douglas, GA 31533-2308 Ph: (912) 389-0042 |
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