| NPI | 1811057250 |
|---|---|
| Doing Business As | MEMORIAL HEALTH FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | ROBIN J. MADDOX Provider Enrollment Coordinator 912-350-9335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2011-06-01 |