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135 Dogwood St Sw Warwick GA 31796-5568 | |
(229) 535-4567 | |
(229) 535-6556 |
Full Name | |
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Speciality | Clinic/Center |
Location | 135 Dogwood St Sw, Warwick, Georgia |
Authorized Official Name and Position | James W. Miller (DIRECTOR PHYSICIAN PRACTICES) |
Authorized Official Contact | 2292714676 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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135 Dogwood St Sw Warwick GA 31796-5568 Ph: (229) 535-4567 | 135 Dogwood St Sw Warwick GA 31796-5568 Ph: (229) 535-4567 |
NPI Number | 1790992352 |
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Provider Enumeration Date | 05/16/2007 |
Last Update Date | 06/12/2009 |
Medicare PECOS PAC ID | 5991616336 |
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Medicare Enrollment ID | O20090609000680 |
Identifier | Type | State | Issuer |
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1790992352 | NPI | - | NPPES |
00000514F | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (Georgia) | Primary |