Organization
SOUTH GEORGIA ALLERGY CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY M DIRTING CPC (BILLING MGR)
(912) 262-9289
Entity
Organization
Contact information
Practice address
2601 PARKWOOD DR, SUITE B, BRUNSWICK, GA 31520-4758
(912) 262-9288
(912) 262-9994
Mailing address
PO BOX 1813, BRUNSWICK, GA 31521-1813
(912) 262-9288
(912) 262-9994
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
GA023506
GA
Other
Enumeration date
01/18/2008
Last updated
11/29/2021
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