| Medical Clinic | |
|
667 Heritage Post Ln Grayson GA 30017-1661 | |
| (770) 962-0041 | |
| (770) 962-0041 |
| Full Name | Medical Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 667 Heritage Post Ln, Grayson, Georgia |
| Authorized Official Name and Position | Jean P. Nazaire (M.D) |
| Authorized Official Contact | 7709620041 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Clinic 667 Heritage Post Ln Po Box 794 Grayson GA 30017-1661 Ph: (770) 962-0041 | Medical Clinic 667 Heritage Post Ln Grayson GA 30017-1661 Ph: (770) 962-0041 |
| NPI Number | 1427377597 |
|---|---|
| Provider Enumeration Date | 05/27/2010 |
| Last Update Date | 05/27/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427377597 | NPI | - | NPPES |
| 2047101 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 060225 (Georgia) | Primary |
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