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Dixie Medical

Clinic/Center, Primary Care in Eastman, GA. Organization (NPI-2).

NPI number1669909172
StatusActive
Last updated in NPPESJul 19, 2023

Details

NPI
1669909172
Entity type
Organization (NPI-2)
Legal business name
Dixie Medical
Organization subpart
No
Enumeration date
May 15, 2017
Certification date
Jul 19, 2023
Last updated
Jul 19, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QP2300X Clinic/Center, Primary CareRN118481GAYes

Practice location

1085 Plaza Ave
Eastman, GA 31023-9102

Phone 478-559-1386 · Fax 478-559-1388

Mailing address

Po Box 146
Chauncey, GA 31011-0146

Phone 478-559-1386 · Fax 478-559-1388

Authorized official

Tonya Lewis
Owner
4785591386

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