| Gwendolyn Moddrell Md Pc | |
|
247 W Main St # B Swainsboro GA 30401-3163 | |
| (478) 237-8101 | |
| (478) 237-8118 |
| Full Name | Gwendolyn Moddrell Md Pc |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 247 W Main St # B, Swainsboro, Georgia |
| Authorized Official Name and Position | Gwendolyn Moddrell (OWNER) |
| Authorized Official Contact | 4782378101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gwendolyn Moddrell Md Pc 247 W Main St # B Swainsboro GA 30401-3163 Ph: (478) 237-8101 | Gwendolyn Moddrell Md Pc 247 W Main St # B Swainsboro GA 30401-3163 Ph: (478) 237-8101 |
| NPI Number | 1992911234 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 08/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992911234 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | (* (Not Available)) | Primary |
Community Service Board Of Middle Georgia Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 133 N Anderson Dr, Swainsboro, GA 30401 Phone: 478-289-2639 Fax: 478-289-2642 | |
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Emanuel Counseling Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 247 W Main St, Suite C, Swainsboro, GA 30401 Phone: 478-289-8147 | |
Ogeechee Behavioral Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 207 N Anderson Dr, Swainsboro, GA 30401 Phone: 478-289-2511 Fax: 478-289-2619 | |
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