Doerun Primary Care Clinic Llc | |
204 N Broad St Doerun GA 31744 | |
(229) 985-3320 | |
(229) 890-1282 |
Full Name | Doerun Primary Care Clinic Llc |
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Speciality | Family Medicine |
Location | 204 N Broad St, Doerun, Georgia |
Authorized Official Name and Position | Jayshree Bhavnani (CFO) |
Authorized Official Contact | 2298919131 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Doerun Primary Care Clinic Llc Po Box 2876 Moultrie GA 31776-2876 Ph: (229) 891-9131 | Doerun Primary Care Clinic Llc 204 N Broad St Doerun GA 31744 Ph: (229) 985-3320 |
NPI Number | 1891480653 |
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Provider Enumeration Date | 04/07/2023 |
Last Update Date | 07/28/2023 |
Medicare PECOS PAC ID | 4880051358 |
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Medicare Enrollment ID | O20230530000612 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891480653 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Doerun Family Medicine Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 128 West Broad Ave, Doerun, GA 31744 Phone: 229-891-9131 Fax: 229-891-9079 |