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Organization
TOTS TO TEENS MEDICAL CENTER
Active
Organization
TOTS TO TEENS MEDICAL CENTER
Active
Other names
Tots To Teens Medical Ctr
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JO E. SMITH CMM (PRACTICE ADMINISTRATOR)
(912) 537-9991
Entity
Organization
Contact information
Practice address
303 HARRIS INDUSTRIAL BLVD., SUITE 1, VIDALIA, GA 30474
(912) 537-9991
(912) 537-9975
Mailing address
PO BOX 569, VIDALIA, GA 30475
(912) 537-9991
(912) 537-9975
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
12/04/2006
Last updated
02/09/2009
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