Organization
SOUTH HEALTH DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYNNE FELDMAN MD, MBA (MEDICAL DIRECTOR)
(229) 333-5290
Entity
Organization
Contact information
Practice address
312 N PATTERSON ST, VALDOSTA, GA 31601-5526
(229) 333-7585
(229) 333-7591
Mailing address
251 APPOMATTOX RD, FITZGERALD, GA 31750-3757
(229) 333-7585
(229) 333-7591
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000052038B
—
GA
01
—
FLU211
MEDICARE PART B
GA
Enumeration date
04/07/2009
Last updated
12/14/2009
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