Organization
SMITH RURAL HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH S WILLIAMSON (CLINIC ADMINISTRATOR)
(478) 237-7517
Entity
Organization
Contact information
Practice address
114 S JEFFERSON ST, SWAINSBORO, GA 30401-3146
(478) 237-7517
(478) 237-4299
Mailing address
PO BOX 160, SWAINSBORO, GA 30401-0160
(478) 237-7517
(478) 237-4299
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
113829
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000241689A
—
GA
05
—
00469664G
—
GA
01
—
034616
GA LISCENSE/AHOWARD
GA
01
—
10047395
AMERIGROUP GA
GA
01
—
10054020
AGROUP/A HOWARD
GA
01
—
1023012580
H WILDER SMITH JR PAC NPI
—
01
—
11BDVCZ
MCAREPARTB/AHOWARD
—
01
—
1225102908
HOWARD MD NPI
—
01
—
1588662506
MASON W SMITH PAC NPI
—
01
—
26760
SRHC UNITED HLTHCARE
—
01
—
336040
WELLCARE GEORGIA
GA
01
—
924053
A HOWARD UNITED HLTHCARE
—
Enumeration date
05/29/2005
Last updated
07/24/2012
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