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Organization
SHAW LIVING PC
Active
Organization
SHAW LIVING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACY BRADFORD (OFFICE MANAGER)
(229) 594-6800
Entity
Organization
Contact information
Practice address
2484 E PINETREE BLVD, THOMASVILLE, GA 31792-4854
(229) 226-8800
(229) 226-8232
Mailing address
2484 E PINETREE BLVD, THOMASVILLE, GA 31792-4854
(229) 594-6800
(833) 464-3427
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/13/2019
Last updated
02/28/2024
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