FJP MEDICAL NPI 1346722964

NPI Information

NPI: 1346722964
Provider Name: FJP MEDICAL

Doing Business As: POWELL TOTAL MEDICAL AND SERENITY

Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

Address:
140 THE LAKES BLVD STE C
KINGSLAND, GA
ZIP 31548
Phone: (912) 729-7246
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FJP MEDICAL is a pain clinic center in Kingsland, GA. FJP MEDICAL NPI is 1346722964. The provider is registered as an organization entity type.
The provider Is Doing Business As Powell Total Medical And Serenity.

The provider's business location address is:

140 THE LAKES BLVD STE C
KINGSLAND, GA
ZIP 31548-814
Phone: (912) 729-7246
Fax: (912) 729-2929

The provider's authorized official is Fred Joe Powell .
The authorized official title is Owner and has the following contact phone number (912) 729-7246.

The CLIA number assigned to this NPI record is 11D2114298 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2018 and was last updated on 8/30/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service	65488	GEORGIA	No
2	261QP3300X	Clinic/Center	Pain	65488	GEORGIA	Yes

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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