Organization
SOUTHEASTERN PATHOLOGY ASSOCIATES AT WAYNE MEMORIAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK E GODBEY M.D. (PRESIDENT)
(912) 261-2669
Entity
Organization
Contact information
Practice address
865 S 1ST ST, JESUP, GA 31545-0210
(912) 261-2669
(912) 261-0561
Mailing address
PO BOX 30309, CHARLESTON, SC 29417-0309
(843) 554-9300
(843) 566-8780
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04833
BSGA WAYNE
GA
Enumeration date
08/22/2006
Last updated
05/21/2008
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