| NPI | 1679933055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY WOOD CFO 706-790-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 059744) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 059744) |
| 261Q00000X Clinic/Center | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: GA 059744) | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2024-11-18 |