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Organization
WAYNE FAMILY PRACTICE ASSOCIATES, P.C.
Active
Organization
WAYNE FAMILY PRACTICE ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN O. KEOWN (PROVIDER/OWNER)
(912) 294-0380
Entity
Organization
Contact information
Practice address
118 AZALEA RD STE 1, BAXLEY, GA 31513-9197
(912) 294-0380
(912) 427-0591
Mailing address
118 AZALEA RD STE 1, BAXLEY, GA 31513-9197
(912) 294-0380
(912) 427-0591
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85001314G
—
GA
Enumeration date
06/19/2006
Last updated
06/27/2025
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