Pavo Primary Care Clinic | |
1103 North Main Street Pavo GA 31778 | |
(229) 859-2622 | |
(229) 859-2885 |
Full Name | Pavo Primary Care Clinic |
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Speciality | Clinic/center - Rural Health |
Location | 1103 North Main Street, Pavo, Georgia |
Authorized Official Name and Position | Charles D. Hightower (CFO) |
Authorized Official Contact | 2292282853 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pavo Primary Care Clinic 920 Cairo Rd Thomasville GA 31792-4255 Ph: (229) 228-8800 | Pavo Primary Care Clinic 1103 North Main Street Pavo GA 31778 Ph: (229) 859-2622 |
NPI Number | 1932296811 |
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Provider Enumeration Date | 10/10/2006 |
Last Update Date | 05/07/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932296811 | NPI | - | NPPES |
000000063H | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 136-91 (Georgia) | Primary |