| |
200 S Cherry St Ocilla GA 31774-1804 | |
(229) 468-5020 | |
(229) 468-5024 |
Full Name | |
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Speciality | Pediatrics |
Location | 200 S Cherry St, Ocilla, Georgia |
Authorized Official Name and Position | Ashley Griffin (CFO) |
Authorized Official Contact | 2294683862 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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710 N Irwin Ave Ocilla GA 31774-5011 Ph: (229) 468-3800 | 200 S Cherry St Ocilla GA 31774-1804 Ph: (229) 468-5020 |
NPI Number | 1033595327 |
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Provider Enumeration Date | 08/10/2015 |
Last Update Date | 11/19/2015 |
Identifier | Type | State | Issuer |
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1033595327 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
208000000X | Pediatrics | (* (Not Available)) | Primary |
Irwin Specialty Centers Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 N Irwin Ave, Ocilla, GA 31774 Phone: 229-468-3800 | |