Organization
COLQUITT FAMILY CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROLAND MANOUTCHEHER BROWN M.D. (OWNER)
(229) 891-2170
Entity
Organization
Contact information
Practice address
2801 S MAIN ST, MOULTRIE, GA 31768-6908
(229) 891-2170
Mailing address
2801 S MAIN ST, MOULTRIE, GA 31768-6908
(229) 891-2170
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
043008
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85001900G
—
GA
Enumeration date
01/16/2007
Last updated
08/22/2020
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