Organization
SOUTH GEORGIA PHYSICIANS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL CRAWFORD DUBOSE (CFO)
(912) 632-8961
Entity
Organization
Contact information
Practice address
1406 HABERSHAM DR, WAYCROSS, GA 31501-5306
(912) 287-1130
(912) 287-9114
Mailing address
204 E 15TH STREET, ALMA, GA 31510-2908
(912) 632-2952
(912) 632-8682
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336560952
GROUP NPI
GA
Enumeration date
04/25/2019
Last updated
05/16/2024
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