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21971 Us Highway 319 N Coolidge GA 31738-3743 | |
(229) 346-3545 | |
(229) 346-6319 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 21971 Us Highway 319 N, Coolidge, Georgia |
Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
Authorized Official Contact | 2164799063 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5500 Maryland Way Ste 400 Brentwood TN 37027-7048 Ph: () - | 21971 Us Highway 319 N Coolidge GA 31738-3743 Ph: (229) 346-3545 |
NPI Number | 1588143663 |
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Provider Enumeration Date | 08/09/2018 |
Last Update Date | 08/24/2022 |
Identifier | Type | State | Issuer |
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1588143663 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |