| NPI | 1912056474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER KOTZ MILLER Owner, Physician 912-267-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 046996) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 029657) |
| 207Q00000X Family Medicine (Licence: GA 052698) | |
| 207Q00000X Family Medicine (Licence: GA 056735) | |
| 207Q00000X Family Medicine (Licence: GA 051731) | |
| 207Q00000X Family Medicine (Licence: GA 040739) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2011-03-17 |