Jennifer Dotson | |
74 Maple Dr Summerville GA 30747-1744 | |
(706) 638-5580 | |
(706) 638-5445 |
Full Name | Jennifer Dotson |
---|---|
Speciality | Community/behavioral Health |
Location | 74 Maple Dr, Summerville, Georgia |
Authorized Official Name and Position | Tom Ford (CEO) |
Authorized Official Contact | 7066385580 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Jennifer Dotson Po Box 1027 La Fayette GA 30728-1027 Ph: (706) 638-5580 | Jennifer Dotson 74 Maple Dr Summerville GA 30747-1744 Ph: (706) 638-5580 |
NPI Number | 1801194113 |
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Provider Enumeration Date | 03/10/2011 |
Last Update Date | 03/10/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801194113 | NPI | - | NPPES |
000604513DQ | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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