| Ga South Family Medicine Residency Program | |
|
1 Magnolia Ct Moultrie GA 31768 | |
| (229) 502-9769 | |
| Not Available |
| Full Name | Ga South Family Medicine Residency Program |
|---|---|
| Speciality | Family Medicine |
| Location | 1 Magnolia Ct, Moultrie, Georgia |
| Authorized Official Name and Position | Stew Merdian (VP OF PHYSICIAN SERVICES) |
| Authorized Official Contact | 2298903531 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ga South Family Medicine Residency Program Po Box 1993 Moultrie GA 31776-1993 Ph: (229) 891-9131 | Ga South Family Medicine Residency Program 1 Magnolia Ct Moultrie GA 31768 Ph: (229) 502-9769 |
| NPI Number | 1962850396 |
|---|---|
| Provider Enumeration Date | 05/26/2016 |
| Last Update Date | 06/28/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962850396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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