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Individual

DR. JACK MARLIN AMIE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2418 PARKWOOD DR, BRUNSWICK, GA 31520-4721
(912) 264-6362
(912) 264-6352
Mailing address
2418 PARKWOOD DR, BRUNSWICK, GA 31520-4721
(912) 264-6362
(912) 264-6352

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
014120
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00083861A
GA
Enumeration date
11/29/2006
Last updated
09/19/2019
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