# OH CLINIC, P.C.

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

## Provider details

- **NPI number:** 1891046017
- **Authorized official:** DR. SANG WAN OH M.D. (PHYSICIAN)
- **Authorized official phone:** (912) 557-4315

## Contact information

- **Practice address:** 257 S MAIN ST, REIDSVILLE, GA 30453-4605
- **Practice address phone:** (912) 557-4315
- **Practice address fax:** (912) 557-3338
- **Mailing address:** PO BOX 519, REIDSVILLE, GA 30453-0519
- **Mailing address phone:** (912) 557-4315
- **Mailing address fax:** (812) 557-3338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 16117 | GA | Yes |

## Other

- **Enumeration date:** 09/27/2012
- **Last updated:** 09/27/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00012317A | — | GA |