# SOUTH GEORGIA PHYSICIANS GROUP, LLC

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

## Provider details

- **NPI number:** 1316501372
- **Authorized official:** CHERYL CRAWFORD DUBOSE (CFO)
- **Authorized official phone:** (912) 632-8961

## Contact information

- **Practice address:** 1406 HABERSHAM DR, WAYCROSS, GA 31501-5306
- **Practice address phone:** (912) 287-1130
- **Practice address fax:** (912) 287-9114
- **Mailing address:** 204 E 15TH STREET, ALMA, GA 31510-2908
- **Mailing address phone:** (912) 632-2952
- **Mailing address fax:** (912) 632-8682

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 04/25/2019
- **Last updated:** 05/16/2024