| Primary Care Of Southwest Georgia, Inc | |
|
283 Martin Luther King Jr Blvd Blakely GA 39823-3455 | |
| (229) 723-4101 | |
| Not Available |
| Full Name | Primary Care Of Southwest Georgia, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 283 Martin Luther King Jr Blvd, Blakely, Georgia |
| Authorized Official Name and Position | Edwin James (CFO) |
| Authorized Official Contact | 2297232660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Of Southwest Georgia, Inc 338 College St Blakely GA 39823-2554 Ph: () - | Primary Care Of Southwest Georgia, Inc 283 Martin Luther King Jr Blvd Blakely GA 39823-3455 Ph: (229) 723-4101 |
| NPI Number | 1932877610 |
|---|---|
| Provider Enumeration Date | 08/30/2021 |
| Last Update Date | 08/30/2021 |
| Medicare PECOS PAC ID | 5496777948 |
|---|---|
| Medicare Enrollment ID | O20210914002983 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932877610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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