Organization
SOUTHERN PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAYESH D PATEL MD (BUSINESS OWNER)
(478) 365-2164
Entity
Organization
Contact information
Practice address
197 BASS RD, MACON, GA 31210-2060
(478) 365-2164
Mailing address
197 BASS RD, MACON, GA 31210-2060
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
07/20/2017
Last updated
01/21/2024
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