Organization · Type 2 NPI
Primary Care of Southwest Georgia, Inc.
Federally Qualified Health Center (FQHC) · Blakely, GA
NPI number
1780607754
Active
Practice location
360 College Street
Blakely, GA 39823
Fax (229) 723-2663
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | 060068 (GA) |
| Internal Medicine Physician | 207R00000X | 057747 (GA) |
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | None listed |
| Family Nurse Practitioner | 363LF0000X | RN188412 (GA) |
Federally Qualified Health Center (FQHC): Definition to come...
Other federally qualified health center (fqhc) providers in Blakely
About NPI 1780607754
Primary Care of Southwest Georgia, Inc.'s National Provider Identifier is 1780607754, issued on Jul 25, 2006. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Blakely, GA. The record was last updated on May 15, 2014.