# THE WIREGRASS MEDICAL & SURGICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083753404
- **Authorized official:** APRIL CLANTON MASSEY (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (229) 524-2706

## Contact information

- **Practice address:** 804 N WILEY AVE, DONALSONVILLE, GA 39845-1120
- **Practice address phone:** (229) 524-2706
- **Practice address fax:** (229) 524-1272
- **Mailing address:** 804 N WILEY AVE, DONALSONVILLE, GA 39845-1120
- **Mailing address phone:** (229) 524-2706
- **Mailing address fax:** (229) 524-1272

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 051586 | GA | Yes |
| 207R00000X | Internal Medicine Physician | 033591 | GA | — |
| 208600000X | Surgery Physician | 019644 | GA | — |
| 208600000X | Surgery Physician | 9288 | GA | — |

## Other

- **Enumeration date:** 02/05/2007
- **Last updated:** 06/21/2018