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105 E Tollison St Ste B Baxley GA 31513-0150 | |
| (912) 366-6600 | |
| (912) 367-7841 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 105 E Tollison St Ste B, Baxley, Georgia |
| Authorized Official Name and Position | Randall Crawford (CEO) |
| Authorized Official Contact | 9123679841 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 2070 Baxley GA 31515-2070 Ph: (912) 366-6600 | 105 E Tollison St Ste B Baxley GA 31513-0150 Ph: (912) 366-6600 |
| NPI Number | 1669726303 |
|---|---|
| Provider Enumeration Date | 11/02/2012 |
| Last Update Date | 04/29/2020 |
| Certification Date | 04/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669726303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 18286 (Georgia) | Primary |
Appling Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 755 S Main St, Baxley, GA 31513 Phone: 912-367-4614 Fax: 912-367-9048 | |
Stepping Stones Therapeutic Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 N Thomas St, Baxley, GA 31513 Phone: 912-278-0551 Fax: 912-208-4100 | |