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Organization
PORT MEDICAL MANAGEMENT INC
Active
Organization
PORT MEDICAL MANAGEMENT INC
Active
Other names
THE BRIDGE
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MOORE (OFFICE MANAGER)
(229) 400-0498
Entity
Organization
Contact information
Practice address
920 S WEST ST, BAINBRIDGE, GA 39819-4581
(229) 400-0498
Mailing address
922 S WEST ST, BAINBRIDGE, GA 39819-4581
(229) 248-8499
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
02/04/2020
Last updated
02/05/2020
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