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SOUTH GEORGIA SPINE AND JOINT CENTER LLC NPI 1770815250


NPI Information

NPI: 1770815250
Provider Name: SOUTH GEORGIA SPINE AND JOINT CENTER, LLC

Doing Business As: SOUTH GEORGIA SPINE AND JOINT CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 11D2033042

Address:
202 S MADISON ST
THOMASVILLE, GA
ZIP 31792
Phone: (229) 226-1035
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SOUTH GEORGIA SPINE AND JOINT CENTER, LLC is a family medicine in Thomasville, GA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SOUTH GEORGIA SPINE AND JOINT CENTER, LLC NPI is 1770815250. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As South Georgia Spine And Joint Center.

The provider's business location address is:

202 S MADISON ST
THOMASVILLE, GA
ZIP 31792-479
Phone: (229) 226-1035
Fax: (229) 226-3378

The provider's authorized official is Michael R Waldrop .
The authorized official title is Owner and has the following contact phone number (229) 226-1035.

The CLIA number assigned to this NPI record is 11D2033042 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/8/2010 and was last updated on 9/18/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225100000XPhysical TherapistNo
2111N00000XChiropractorNo
3332B00000XDurable Medical Equipment & Medical SuppliesNo
4207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
16405060001MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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