| Southwest Medical Clinic, Inc | |
|
64 Jones Mill Road Suite B Box 517 Woodbury GA 30293 | |
| (706) 553-3270 | |
| Not Available |
| Full Name | Southwest Medical Clinic, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 64 Jones Mill Road, Woodbury, Georgia |
| Authorized Official Name and Position | Obinna B Ubani-ebere (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 7065533270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Medical Clinic, Inc Po Box 517 64b Jones Mill Road Woodbury GA 30293 Ph: (706) 553-3270 | Southwest Medical Clinic, Inc 64 Jones Mill Road Suite B Box 517 Woodbury GA 30293 Ph: (706) 553-3270 |
| NPI Number | 1750593430 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 02/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750593430 | NPI | - | NPPES |
| 000719947AG | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 042618 (Georgia) | Primary |
Warm Springs Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 64a Jones Mill Rd, Woodbury, GA 30293 Phone: 706-553-5367 Fax: 706-553-5370 |