Organization
SOUTH GEORGIA REGIONAL ANESTHESIA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM S WILLS (COMPLIANCE OFFICER)
(229) 671-2019
Entity
Organization
Contact information
Practice address
4280 N VALDOSTA RD, VALDOSTA, GA 31602-6814
(229) 219-0350
Mailing address
PO BOX 3267, VALDOSTA, GA 31604-3267
(229) 219-0350
(229) 219-0349
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/18/2006
Last updated
11/19/2007
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