| NPI | 1083782189 |
|---|---|
| Doing Business As | URGENTONE GODLEY STATION |
| Entity Type | Organization |
| Authorized Contact | ROBIN J. MADDOX Provider Enrollment Coordinator 912-350-9335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 208D00000X General Practice | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2011-05-20 |