Organization
MILLEDGEVILLE FAMILLY PRACTICE CENTER P.C.
Active
Parent organization
MILLEDGEVILLE
Organization subpart
Yes
Provider details
NPI number
Legal business name
MILLEDGEVILLE
Authorized official
DR. GEORGE W GRIMES III M.D. (DOCTOR)
(478) 453-9435
Entity
Organization
Contact information
Practice address
540 W THOMAS ST STE B, MILLEDGEVILLE, GA 31061-2745
(478) 453-9435
(478) 453-9436
Mailing address
540 W THOMAS ST STE B, MILLEDGEVILLE, GA 31061-2745
(478) 453-9435
(478) 453-9436
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19830
GA
207VX0000X
Obstetrics Physician
19830
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00201517A
—
GA
Enumeration date
12/18/2007
Last updated
12/18/2007
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