| |
840 Professional Center Dr Eastman GA 31023-6734 | |
(478) 374-7801 | |
(478) 374-7878 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 840 Professional Center Dr, Eastman, Georgia |
Authorized Official Name and Position | Jan Hamrick (CFO) |
Authorized Official Contact | 4784484050 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
840 Professional Center Dr Eastman GA 31023-6734 Ph: (478) 374-7801 | 840 Professional Center Dr Eastman GA 31023-6734 Ph: (478) 374-7801 |
NPI Number | 1255948717 |
---|---|
Provider Enumeration Date | 09/29/2020 |
Last Update Date | 06/13/2023 |
Medicare PECOS PAC ID | 1759372733 |
---|---|
Medicare Enrollment ID | O20120105001025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255948717 | NPI | - | NPPES |
003257063A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Mid Georgia Total Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1111 Griffin Ave, Ste 1b, Eastman, GA 31023 Phone: 478-374-8998 Fax: 478-374-8525 | |
Heather T Herrington Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 830 Professional Center Dr, Eastman, GA 31023 Phone: 478-374-8737 Fax: 478-374-8823 |