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Jose Medina Md Pc
Multi-Specialty Clinic/Center in Valdosta, Georgia
NPI 1407047269

Jose Medina Md Pc is a Multi-Specialty Clinic/Center based in Valdosta, GA and is specialized in Multi-Specialty. Jose Medina Md Pc practices in Valdosta, GA. The NPI Number for Jose Medina Md Pc is 1407047269 and holds a License No. 041166 (Georgia).

The current practice location address for Jose Medina Md Pc is 3334 Greystone Way, Valdosta, GA and can be reached out via phone at 229-247-1667 and via fax at 229-247-3456.

Location: 3334 Greystone Way, Valdosta, GA, 31604-3550
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1407047269
Provider Name
Jose Medina Md Pc
Credential
Provider Entity Type
Organization
Address
3334 Greystone Way, Valdosta, GA, 31604-3550
Phone Number
229-247-1667
Fax Number
229-247-3456
Provider Enumeration Date
08/07/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00686507C 05 GA
institution
Provider Business Practice Location Address Details
Address
3334 Greystone Way
City
Valdosta
State
Georgia
Zip
31605-1096
Phone Number
229-247-1667
Fax Number
229-247-3456
person
Provider Business Mailing Address Details
Address
3334 Greystone Way
City
Valdosta
State
Georgia
Zip
31605-1096
Phone Number
229-247-1667
Fax Number
229-247-3456
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
261QM1300X
License No.
041166 (Georgia)
Definition
Definition to come...
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