Organization
GRACE MEDICAL CLINIC
Active
Organization
GRACE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EHI PHILIP OSEHOBO M.D. (MEDICAL DIRECTOR)
(678) 688-1155
Entity
Organization
Contact information
Practice address
230 W COLLEGE ST, B, GRIFFIN, GA 30224-4121
(678) 688-1155
(678) 688-5071
Mailing address
230 W COLLEGE ST, B, GRIFFIN, GA 30224-4121
(678) 688-1155
(678) 688-5071
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
049075
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187778601A
—
GA
Enumeration date
11/14/2006
Last updated
08/11/2010
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