# SOUTH GA GASTROENTEROLOGY & NUTRITION SUPPORT, INC.

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

## Provider details

- **NPI number:** 1609938026
- **Authorized official:** MRS. LINDA KAY COLE CPC-RMC (PRACTICE MANAGER)
- **Authorized official phone:** (229) 985-1230

## Contact information

- **Practice address:** 2509 S MAIN ST, MOULTRIE, GA 31768-6530
- **Practice address phone:** (229) 985-1230
- **Practice address fax:** (229) 985-1233
- **Mailing address:** 2509 S MAIN ST, MOULTRIE, GA 31768-6530
- **Mailing address phone:** (229) 985-1230
- **Mailing address fax:** (229) 985-1233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | 46662 | GA | Yes |

## Other

- **Enumeration date:** 12/14/2006
- **Last updated:** 01/04/2010