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Organization

NICHOLLS FAMILY HEALTH CARE, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WINTON COPE MCNAIR III (PRESIDENT/CEO)
(678) 778-8924
Entity
Organization

Contact information

Practice address
1205 VAN STREAT HWY, NICHOLLS, GA 31554-5025
(912) 345-2474
(912) 345-2518
Mailing address
1205 VAN STREAT HWY, NICHOLLS, GA 31554-5025
(912) 345-2474
(912) 345-2518

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
016807
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00274799A
GA
Enumeration date
01/03/2008
Last updated
01/03/2008
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