Organization
MACON COUNTY CONVENIENT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QUINCY J JORDAN M.D. (PHYSICIAN)
(404) 938-6439
Entity
Organization
Contact information
Practice address
512 SUMTER ST, MONTEZUMA, GA 31063-1758
(404) 938-6439
Mailing address
512 SUMTER ST, MONTEZUMA, GA 31063-1758
(404) 938-6439
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000506437G
—
GA
Enumeration date
10/10/2013
Last updated
05/30/2014
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