# INTEGRATED TELEHEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INTEGRATED TELEHEALTH LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1699299842
- **Legal business name:** INTEGRATED TELEHEALTH LLC
- **Authorized official:** DR. JON C GIBBS MD (DIRECTOR)
- **Authorized official phone:** (706) 831-0204

## Contact information

- **Practice address:** 1523 OLD VALDOSTA RD STE B, RAY CITY, GA 31645
- **Practice address phone:** (877) 543-7221
- **Practice address fax:** (877) 755-2212
- **Mailing address:** 1523 OLD VALDOSTA RD STE B, RAY CITY, GA 31645-7132
- **Mailing address phone:** (877) 543-7221
- **Mailing address fax:** (877) 755-2212

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 07/31/2017
- **Last updated:** 08/16/2018