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COLQUITT REGIONAL MEDICAL CENTER NPI 1962850396


NPI Information

NPI: 1962850396
Provider Name: COLQUITT REGIONAL MEDICAL CENTER

Doing Business As: GA SOUTH FAMILY MEDICINE RESIDENCY PROGRAM

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 11D2122192

Address:
1 MAGNOLIA CT
MOULTRIE, GA
ZIP 31768
Phone: (229) 502-9769
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COLQUITT REGIONAL MEDICAL CENTER is a family medicine in Moultrie, 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. COLQUITT REGIONAL MEDICAL CENTER NPI is 1962850396. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ga South Family Medicine Residency Program.

The provider's business location address is:

1 MAGNOLIA CT
MOULTRIE, GA
ZIP 31768
Phone: (229) 502-9769

The provider's authorized official is Stew Merdian .
The authorized official title is Vp Of Physician Services and has the following contact phone number (229) 890-3531.

The CLIA number assigned to this NPI record is 11D2122192 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/26/2016 and was last updated on 6/28/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

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: 11/14/2023

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