Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2006-11-16
- Last updated
- 2008-12-15
Licenses
The registry row did not include a license.
Location
- Practice location
- 1200 ROUNDTREE ST
- City
- QUITMAN GA
- Postal code
- 316433712
- Phone
- 229-263-7510
Organization contact
- Name
- SUE GUPTON
- Title
- Chief Executive Officer
- Phone
- 2296716101
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.