| Ich Physician Group | |
|
134 Fleetwood Ave E Willacoochee GA 31650-2730 | |
| (912) 534-5142 | |
| (912) 534-6120 |
| Full Name | Ich Physician Group |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 134 Fleetwood Ave E, Willacoochee, Georgia |
| Authorized Official Name and Position | Jeanne Blevins (COO) |
| Authorized Official Contact | 2294683800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ich Physician Group 710 N Irwin Ave Ocilla GA 31774-5011 Ph: (229) 468-3800 | Ich Physician Group 134 Fleetwood Ave E Willacoochee GA 31650-2730 Ph: (912) 534-5142 |
| NPI Number | 1649670894 |
|---|---|
| Provider Enumeration Date | 08/25/2014 |
| Last Update Date | 05/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649670894 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Douglas Medical Specialist Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 134 E Fleetwood Ave, Willacoochee, GA 31650 Phone: 912-384-3338 Fax: 912-383-6365 |