Ben Hill Family Medicine | |
708 S Grant St Ste 15 Fitzgerald GA 31750-5707 | |
(912) 309-3338 | |
Not Available |
Full Name | Ben Hill Family Medicine |
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Speciality | Clinic/Center |
Location | 708 S Grant St Ste 15, Fitzgerald, Georgia |
Authorized Official Name and Position | Beverly Denise Graham (NURSE PRACTITIONER/INCORPORATOR) |
Authorized Official Contact | 9122536163 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ben Hill Family Medicine Po Box 280 Fitzgerald GA 31750-0280 Ph: (912) 253-6163 | Ben Hill Family Medicine 708 S Grant St Ste 15 Fitzgerald GA 31750-5707 Ph: (912) 309-3338 |
NPI Number | 1184492878 |
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Provider Enumeration Date | 12/13/2023 |
Last Update Date | 06/11/2024 |
Medicare PECOS PAC ID | 8022457670 |
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Medicare Enrollment ID | O20240416002987 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184492878 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Beverly D Graham |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316451735 PECOS PAC ID: 9436494572 Enrollment ID: I20181218004024 |
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