# EMERGENCY PHYSICIANS OF COFFEE COUNTY, LLC

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

## Provider details

- **NPI number:** 1336431030
- **Authorized official:** LAVONDA CRAVEY (MANAGER)
- **Authorized official phone:** (912) 384-1900

## Contact information

- **Practice address:** 1101 OCILLA RD, DOUGLAS, GA 31533-2207
- **Practice address phone:** (912) 384-1900
- **Practice address fax:** (912) 383-5667
- **Mailing address:** 1101 OCILLA RD, DOUGLAS, GA 31533-2207
- **Mailing address phone:** (912) 384-1900
- **Mailing address fax:** (912) 383-5667

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/12/2011
- **Last updated:** 05/12/2011