| Dr. Leon Gresham | |
|
100 S Court St Calhoun GA 30701-2296 | |
| (706) 629-8266 | |
| (706) 629-8267 |
| Full Name | Dr. Leon Gresham |
|---|---|
| Speciality | Clinic/center |
| Location | 100 S Court St, Calhoun, Georgia |
| Authorized Official Name and Position | Leon Gresham (OWNER) |
| Authorized Official Contact | 7066298266 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Leon Gresham 100 S Court St Calhoun GA 30701-2296 Ph: (706) 629-8266 | Dr. Leon Gresham 100 S Court St Calhoun GA 30701-2296 Ph: (706) 629-8266 |
| NPI Number | 1801064803 |
|---|---|
| Provider Enumeration Date | 02/13/2008 |
| Last Update Date | 02/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801064803 | NPI | - | NPPES |
| 00005233A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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