Unknown Individual – Specialist, NPI 1336241645
Specialist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
PO BOX 2169
MOULTRIE, GA 317762169
Phone: (229) 891-9028
Fax: (229) 891-9033
Type: Mailing
3, Magnolia Court, Moultrie, Colquitt County, Georgia, 31768, United States
MOULTRIE, GA 317686764
Phone: (229) 891-9028
Fax: (229) 891-9033
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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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 ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 31776)
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