| NPI | 1235392408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINNIE CLAIRE HICKS Medical Doctor 912-588-2511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 029466) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2008-07-08 |