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509 Sumter Street Montezuma GA 31063-1733 | |
(478) 472-3100 | |
(478) 472-2412 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 509 Sumter Street, Montezuma, Georgia |
Authorized Official Name and Position | Philip H Eastman (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 4784723100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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509 Sumter Street Po Box 770 Montezuma GA 31063-1733 Ph: (478) 472-3100 | 509 Sumter Street Montezuma GA 31063-1733 Ph: (478) 472-3100 |
NPI Number | 1518026202 |
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Provider Enumeration Date | 12/08/2006 |
Last Update Date | 03/23/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518026202 | NPI | - | NPPES |
000149487B | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 094-391 (Georgia) | Primary |
William M. Mcdonald, D.o. Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 Sumter St, Montezuma, GA 31063 Phone: 478-472-6713 Fax: 478-472-5142 | |
Flint River Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 Sumter St, Montezuma, GA 31063 Phone: 478-472-6713 Fax: 478-472-5142 | |