Unknown Individual – Family Medicine Physician, NPI 1245314053

Unknown Individual is a healthcare provider. based in Claxton, Georgia. specializing in Family Medicine Physician. They hold a License No. 054741 (GA). The NPI Number for Unknown Individual is 1245314053

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1245314053
Phone
(912) 739-8001
Address
501 E. LONG STREET
Deactivation Date
28 April 2021
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

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Provider Addresses for Unknown Individual

  • 501, East Long Street, Claxton, Evans County, Georgia, 30417, United States

    CLAXTON, GA 30417

    Phone: (912) 739-8001

    Fax: (912) 739-8738

    Mailing address matches the actual address.

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.

This can happen when there are no reportable CMS Open Payments records.

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 30417)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1245314053 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Georgia is Unknown Individual registered?
Use Claxton, Georgia as the headline location for Unknown Individual here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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