Organization · Type 2 NPI

Ich Physician Group

Rural Health Clinic/Center · Willacoochee, GA

NPI number 1649670894 Active

Practice location

134 Fleetwood Ave E
Willacoochee, GA 31650-2730

Call (912) 534-5142 Map

Fax (912) 534-6120

Mailing address

710 N Irwin Ave
Ocilla, GA 31774-5011

Specialties and licenses

Taxonomy	Code	License
Internal Medicine Physician	207R00000X	None listed
Rural Health Clinic/Center Primary	261QR1300X	None listed

Rural Health Clinic/Center: Definition to come...

Another provider at this address

John David Rowe Jr., PHYSICIAN ASSISTANTPhysician Assistant Willacoochee, GA NPI 1891815924

NPI record

NPI: 1649670894
Entity type: Organization (Type 2)
Issued: Aug 25, 2014
Last updated: Feb 27, 2025
Status: Active

Other names

<unavail>
Willacoochee Clinic · doing business as
Irwin County Hospital Authority · former legal business name

Authorized official

Krystal Carver
CFO
(229) 468-3846

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1649670894

Ich Physician Group's National Provider Identifier is 1649670894, issued on Aug 25, 2014. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Willacoochee, GA. The record was last updated on Feb 27, 2025.