| NPI | 1043384183 |
|---|---|
| Doing Business As | STATESBORO FAMILY PRACTICE CLINIC |
| Entity Type | Organization |
| Authorized Contact | TERI S DAIGNEAULT Medical Coder 912-764-1039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 18745) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 029847) |
| 207Q00000X Family Medicine (Licence: GA 048703) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |