| |
300 Arlington Dr. Vidalia GA 30474 | |
(912) 538-0830 | |
(912) 538-1333 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 300 Arlington Dr., Vidalia, Georgia |
Authorized Official Name and Position | John Burton Derrick (CEO) |
Authorized Official Contact | 9125380830 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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300 Arlington Dr. Po Box 645 Vidalia GA 30475-0645 Ph: (912) 538-0830 | 300 Arlington Dr. Vidalia GA 30474 Ph: (912) 538-0830 |
NPI Number | 1508910241 |
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Provider Enumeration Date | 01/22/2007 |
Last Update Date | 01/28/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508910241 | NPI | - | NPPES |
00741243A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Wheeler County Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Maple Dr, Vidalia, GA 30474 Phone: 912-537-0616 Fax: 912-537-0617 | |
Vidalia Family Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1702 Meadows Ln, Vidalia, GA 30474 Phone: 912-805-2198 Fax: 912-805-2997 | |
Wiggins Family Practice Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 Arlington Dr, Vidalia, GA 30474 Phone: 912-537-2530 Fax: 912-537-2540 | |
Vidalia Neurology Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1707 Meadows Lane, Suite A, Vidalia, GA 30474 Phone: 912-537-9779 |