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Southwest Ga Primary Care, Llc
Primary Care Clinic/Center in Ellaville, Georgia
NPI 1629400312

Southwest Ga Primary Care, Llc is a Primary Care Clinic/Center based in Ellaville, GA and is specialized in Primary Care. Southwest Ga Primary Care, Llc practices in Ellaville, GA. The NPI Number for Southwest Ga Primary Care, Llc is 1629400312 and holds a License No. 33367 (Georgia).

The current practice location address for Southwest Ga Primary Care, Llc is 93 S Broad St, Ellaville, GA and can be reached out via phone at 229-410-9965 and via fax at 229-937-9007.

Location: 93 S Broad St, Ellaville, GA, 31806-0989
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1629400312
Provider Name
Southwest Ga Primary Care, Llc
Credential
Provider Entity Type
Organization
Address
93 S Broad St, Ellaville, GA, 31806-0989
Phone Number
229-410-9965
Fax Number
229-937-9007
Provider Enumeration Date
08/05/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000506437G 05 GA
institution
Provider Business Practice Location Address Details
Address
93 S Broad St
City
Ellaville
State
Georgia
Zip
31806-0989
Phone Number
229-410-9965
Fax Number
229-937-9007
person
Provider Business Mailing Address Details
Address
93 S Broad St
City
Ellaville
State
Georgia
Zip
31806-0989
Phone Number
229-410-9965
Fax Number
229-937-9007
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
33367 (Georgia)
Definition
Definition to come...
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