# DMC PHYSICIAN GROUP LLC

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

## Provider details

- **NPI number:** 1124430020
- **Authorized official:** MRS. PAIGE WYNN (INTERIM CEO)
- **Authorized official phone:** (478) 289-1376

## Contact information

- **Practice address:** 200 PERRY HOUSE RD, FITZGERALD, GA 31750-8857
- **Practice address phone:** (229) 424-7260
- **Mailing address:** 200 PERRY HOUSE RD, FITZGERALD, GA 31750-8857
- **Mailing address phone:** (229) 424-7260

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208M00000X | Hospitalist Physician | — | NULL | — |
| 208M00000X | Hospitalist Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | — |
| 273R00000X | Psychiatric Hospital Unit | — | NULL | — |
| 282NR1301X | Rural Acute Care Hospital | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 05/27/2014
- **Last updated:** 05/19/2025