Primary Care Of Southwest Georgia, Inc. | |
360 College Street Blakely GA 39823 | |
(229) 723-2660 | |
(229) 723-2663 |
Full Name | Primary Care Of Southwest Georgia, Inc. |
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Speciality | Clinic/Center |
Location | 360 College Street, Blakely, Georgia |
Authorized Official Name and Position | Edwin V James (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 2297232660 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Primary Care Of Southwest Georgia, Inc. 360 College Street Blakely GA 39823 Ph: (229) 723-2660 | Primary Care Of Southwest Georgia, Inc. 360 College Street Blakely GA 39823 Ph: (229) 723-2660 |
NPI Number | 1780607754 |
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Provider Enumeration Date | 07/25/2006 |
Last Update Date | 05/15/2014 |
Medicare PECOS PAC ID | 5496777948 |
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Medicare Enrollment ID | O20100730000980 |
Identifier | Type | State | Issuer |
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1780607754 | NPI | - | NPPES |
024893266A | Medicaid | GA |
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