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1303 E Union St Suite 102 Vienna GA 31092-7540 | |
(229) 268-8321 | |
(229) 268-8323 |
Full Name | |
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Speciality | Family Medicine |
Location | 1303 E Union St, Vienna, Georgia |
Authorized Official Name and Position | Nikki Paulk (COO) |
Authorized Official Contact | 4787830200 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1297 Hawkinsville GA 31036-7297 Ph: (478) 783-0200 | 1303 E Union St Suite 102 Vienna GA 31092-7540 Ph: (229) 268-8321 |
NPI Number | 1780934539 |
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Provider Enumeration Date | 09/19/2012 |
Last Update Date | 10/22/2012 |
Identifier | Type | State | Issuer |
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1780934539 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |