Organization
BAXLEY MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES ADRIAN GRAHAM M.D. (OWNER)
(912) 367-9112
Entity
Organization
Contact information
Practice address
331 S MAIN ST, BAXLEY, GA 31513-0109
(912) 367-9112
(912) 367-6233
Mailing address
331 S MAIN ST, BAXLEY, GA 31513-0109
(912) 367-9112
(912) 367-6233
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
057979
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
662027563E
—
GA
Enumeration date
12/27/2007
Last updated
04/15/2010
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