Baxley Medical Clinic, Llc | |
331 S Main St Baxley GA 31513-0109 | |
(912) 367-9112 | |
(912) 367-6233 |
Full Name | Baxley Medical Clinic, Llc |
---|---|
Speciality | Family Medicine |
Location | 331 S Main St, Baxley, Georgia |
Authorized Official Name and Position | James Adrian Graham (OWNER) |
Authorized Official Contact | 9123679112 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Baxley Medical Clinic, Llc 331 S Main St Baxley GA 31513-0109 Ph: (912) 367-9112 | Baxley Medical Clinic, Llc 331 S Main St Baxley GA 31513-0109 Ph: (912) 367-9112 |
NPI Number | 1174707103 |
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Provider Enumeration Date | 12/27/2007 |
Last Update Date | 04/15/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174707103 | NPI | - | NPPES |
662027563E | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 057979 (Georgia) | Primary |
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