| Doerun Family Medicine Clinic | |
|
128 West Broad Ave Doerun GA 31744 | |
| (229) 891-9131 | |
| (229) 891-9079 |
| Full Name | Doerun Family Medicine Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 128 West Broad Ave, Doerun, Georgia |
| Authorized Official Name and Position | Wendell Larry Sims (CFO) |
| Authorized Official Contact | 2299853420 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Doerun Family Medicine Clinic Po Box 624 Doerun GA 31744-0624 Ph: (229) 891-9131 | Doerun Family Medicine Clinic 128 West Broad Ave Doerun GA 31744 Ph: (229) 891-9131 |
| NPI Number | 1992147573 |
|---|---|
| Provider Enumeration Date | 07/23/2013 |
| Last Update Date | 05/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992147573 | NPI | - | NPPES |
| 11-8911 | Other | GA | MEDICARE PART A |
| 003157266A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Georgia) | Primary |
Doerun Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 128 West Broad Avenue, Doerun, GA 31744 Phone: 229-782-5227 Fax: 229-782-5228 | |
Doerun Primary Care Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 204 N Broad St, Doerun, GA 31744 Phone: 229-985-3320 Fax: 229-890-1282 |