Organization · NPI-2

Faith Family Practice LLC

Family Medicine · Waycross, GA

NPI number1649819343
StatusActive
Last updated in NPPESJan 8, 2026

Details

NPI
1649819343
Entity type
Organization (NPI-2)
Legal business name
Faith Family Practice LLC
Organization subpart
No
Enumeration date
Dec 27, 2019
Certification date
Jan 8, 2026
Last updated
Jan 8, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

2100 Riverside Ave
Waycross, GA 31501-7020

Phone 912-490-7777 · Fax 912-490-7778

Mailing address

Po Box 741
Waycross, GA 31502-0741

Phone 912-490-7777 · Fax 912-490-7778

Authorized official

Mary Elizabeth Page
Owner
9124907777

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