# MAGNOLIA MEDICAL

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

## Provider details

- **NPI number:** 1649445271
- **Authorized official:** DANE KENDALL GREGORY MD (PHYSICIAN)
- **Authorized official phone:** (706) 629-8622

## Contact information

- **Practice address:** 185 PROFESSIONAL CT SE STE C, CALHOUN, GA 30701-7030
- **Practice address phone:** (706) 629-8622
- **Practice address fax:** (706) 629-8674
- **Mailing address:** PO BOX 2726, CALHOUN, GA 30703-2726
- **Mailing address phone:** (706) 629-8622
- **Mailing address fax:** (706) 629-8674

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/24/2008
- **Last updated:** 04/24/2008