Unknown Individual – Internal Medicine Physician, NPI 1093793606

Unknown Individual is a healthcare provider. based in Waycross, Georgia. specializing in Internal Medicine Physician. They hold a License No. 047233 (GA). The NPI Number for Unknown Individual is 1093793606

Main info

Organization
Inactive
27 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1093793606
Phone
(912) 278-4335
Address
1306 SATILLA BLVD
Deactivation Date
18 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1999 (27 years ago)
PAC ID
7810891835
Professional Enrollment ID
I20031125000585
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • Satilla Boulevard, Waycross, Ware County, Georgia, 31501, United States

    WAYCROSS, GA 315014308

    Phone: (912) 278-4335

    Type: Mailing

  • 86034 Sinatra St

    Yulee, FL 320973907

    Phone: (912) 278-4335

    Type: Location

  • Jesup Drive-in Theatre, 3686, Savannah Highway, Jesup, Wayne County, Georgia, 31545, United States

    JESUP, GA 315455514

    Phone: (912) 278-4335

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31501)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1093793606 uniquely identifies Unknown Individual in U.S. healthcare data.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Waycross, Georgia?
For routing, start with Waycross, Georgia for Unknown Individual, then verify phone and hours locally.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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