South Georgia Allergy Clinic PC
Allergy & Immunology in Brunswick, GA. Organization (NPI-2).
NPI number1285810366
StatusActive
Last updated in NPPESNov 29, 2021
Details
- NPI
- 1285810366
- Entity type
- Organization (NPI-2)
- Legal business name
- South Georgia Allergy Clinic PC
- Organization subpart
- No
- Enumeration date
- Jan 18, 2008
- Certification date
- Nov 29, 2021
- Last updated
- Nov 29, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207K00000X | Allergy & Immunology | GA023506 | GA | Yes |
Practice location
2601 Parkwood DrSuite B
Brunswick, GA 31520-4758
Phone 912-262-9288 · Fax 912-262-9994
Mailing address
Po Box 1813Brunswick, GA 31521-1813
Phone 912-262-9288 · Fax 912-262-9994
Authorized official
Kelly M Dirting
Billing Mgr
9122629289
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