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501 E Long St Claxton GA 30417-1435 | |
(912) 739-8001 | |
(912) 739-8738 |
Full Name | |
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Speciality | Family Medicine |
Location | 501 E Long St, Claxton, Georgia |
Authorized Official Name and Position | John Wiggins (CFO) |
Authorized Official Contact | 9127395000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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200 N River St Claxton GA 30417-1659 Ph: (912) 739-5000 | 501 E Long St Claxton GA 30417-1435 Ph: (912) 739-8001 |
NPI Number | 1134453111 |
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Provider Enumeration Date | 09/24/2009 |
Last Update Date | 08/02/2011 |
Identifier | Type | State | Issuer |
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1134453111 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (Georgia) | Primary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |