Organization
ARCHBOLD MEDICAL GROUP
Active
Other names
Gerry Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES D HIGHTOWER (CHIEF FINANCIAL OFFICER)
(229) 228-2853
Entity
Organization
Contact information
Practice address
555 N JEFFERSON ST, MONTICELLO, FL 32344-2060
(850) 997-2511
(850) 997-3022
Mailing address
900 CAIRO RD, THOMASVILLE, GA 31792
(229) 227-5104
(229) 227-5187
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0085940
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D0270322
CLIA
—
05
—
267978700
—
FL
Enumeration date
07/07/2006
Last updated
10/07/2009
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