Organization
ICH PHYSICIAN GROUP
Active
Organization
ICH PHYSICIAN GROUP
Active
Other names
Irwin County Hospital Authority
Organization subpart
No
Provider details
NPI number
Authorized official
MARY DEMIAN (CEO)
(229) 468-3846
Entity
Organization
Contact information
Practice address
710 N IRWIN AVE, OCILLA, GA 31774-5011
(229) 468-3800
Mailing address
710 N IRWIN AVE, OCILLA, GA 31774-5011
(229) 468-3800
(229) 468-9991
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208600000X
Surgery Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/19/2018
Last updated
03/17/2026
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