# STATHAM MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1447442959
- **Authorized official:** DR. FELIPE R MUSNGI (PRESIDENT)
- **Authorized official phone:** (770) 725-7994

## Contact information

- **Practice address:** 337 JEFFERSON ST., STATHAM, GA 30666
- **Practice address phone:** (770) 725-7994
- **Practice address fax:** (770) 725-7994
- **Mailing address:** 337 JEFFERSON STREET, STATHAM, GA 30666
- **Mailing address phone:** (770) 725-7994
- **Mailing address fax:** (770) 725-7994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 023195 | GA | Yes |

## Other

- **Enumeration date:** 08/17/2007
- **Last updated:** 08/17/2007