| NPI | 1962579268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY S COCHRAN President 706-896-0544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 52235849) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN053003) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2025-09-11 |