| Statesboro Family Practice Clinic | |
|
412 Northside Dr E Suite 200 Statesboro GA 30458-4802 | |
| (912) 764-9684 | |
| (912) 489-8676 |
| Full Name | Statesboro Family Practice Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 412 Northside Dr E, Statesboro, Georgia |
| Authorized Official Name and Position | Teri S Daigneault (MEDICAL CODER) |
| Authorized Official Contact | 9127641039 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Statesboro Family Practice Clinic 412 Northside Dr E Suite 200 Statesboro GA 30458-4802 Ph: (912) 764-9684 | Statesboro Family Practice Clinic 412 Northside Dr E Suite 200 Statesboro GA 30458-4802 Ph: (912) 764-9684 |
| NPI Number | 1043384183 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043384183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 18745 (Georgia) | Primary |
| 207Q00000X | Family Medicine | 029847 (Georgia) | Secondary |
| 207Q00000X | Family Medicine | 048703 (Georgia) | Secondary |
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