Organization
SOUTHEAST GEORGIA PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW G PROHASKA D.O. (DOCTOR)
(912) 283-1359
Entity
Organization
Contact information
Practice address
409 UVALDA ST, WAYCROSS, GA 31501-4574
(912) 283-1359
(912) 283-1362
Mailing address
409 UVALDA ST, WAYCROSS, GA 31501-4574
(912) 283-1359
(912) 283-1362
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/25/2006
Last updated
08/22/2020
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