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Organization
FAMILY PRACTICE HEALTHCARE CLINIC/URGENT CARE CLINIC, LLC
Active
Organization
FAMILY PRACTICE HEALTHCARE CLINIC/URGENT CARE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDMUND MATTHEW WRIGHT M.D. (PHYCIAN/OWNER)
(229) 868-2831
Entity
Organization
Contact information
Practice address
10 NORTH 3RD AVENUE, MCRAE, GA 31055
(229) 868-2831
Mailing address
10 NORTH 3RD AVENUE, MCRAE, GA 31055
(229) 868-2831
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
037111GA
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202G086558
MEDICARE
—
05
—
522838074A
—
GA
Enumeration date
09/04/2015
Last updated
09/04/2015
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