| Archway Medical Center | |
|
735 Martin Rd Suite A Jasper GA 30143-8411 | |
| (706) 253-3366 | |
| (706) 253-2243 |
| Full Name | Archway Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 735 Martin Rd, Jasper, Georgia |
| Authorized Official Name and Position | Richard D Gonzales (PRESIDENT) |
| Authorized Official Contact | 7062533366 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Archway Medical Center 735 Martin Rd Suite A Jasper GA 30143-8411 Ph: (706) 253-3366 | Archway Medical Center 735 Martin Rd Suite A Jasper GA 30143-8411 Ph: (706) 253-3366 |
| NPI Number | 1295880565 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 12/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295880565 | NPI | - | NPPES |
| 00804251B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 044925 (Georgia) | Primary |
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