# COLQUITT REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Georgia South Family Medicine, GA South Family Medicine Residency Program
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962850396
- **Authorized official:** JAMES L MATNEY (CEO)
- **Authorized official phone:** (229) 985-3420

## Contact information

- **Practice address:** 3131 S MAIN ST, MOULTRIE, GA 31768-6925
- **Practice address phone:** (229) 502-9769
- **Practice address fax:** (229) 985-3751
- **Mailing address:** PO BOX 2876, MOULTRIE, GA 31776-2876
- **Mailing address phone:** (229) 891-9131

## Taxonomy

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

## Other

- **Enumeration date:** 05/26/2016
- **Last updated:** 09/04/2025