DMC PHYSICIAN GROUP LLC NPI 1619541018

NPI Information

NPI: 1619541018
Provider Name: DMC PHYSICIAN GROUP LLC

Doing Business As: DMC PRIMARY CARE

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
246 BENJAMIN H HILL DR SW
FITZGERALD, GA
ZIP 31750
Phone: (229) 409-0874
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DMC PHYSICIAN GROUP LLC is a rural health clinic center in Fitzgerald, GA. DMC PHYSICIAN GROUP LLC NPI is 1619541018. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Dmc Primary Care.

The provider's business location address is:

246 BENJAMIN H HILL DR SW
FITZGERALD, GA
ZIP 31750-695
Phone: (229) 409-0874

The provider's authorized official is Paige Wynn .
The authorized official title is Ceo and has the following contact phone number (229) 424-7100.

The CLIA number assigned to this NPI record is 11D2159234 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/19/2021 and was last updated on 3/21/2022.

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	207Q00000X	Family Medicine				No
2	261QR1300X	Clinic/Center	Rural Health			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

NPI Synchronization or Removal

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