Organization
NUMI WELLNESS AND DIABETES CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON HOLLIS DO (OWNER)
(276) 591-8383
Entity
Organization
Contact information
Practice address
1525 FAIR RD STE 105A, STATESBORO, GA 30458-6118
(276) 591-8383
(912) 259-9509
Mailing address
1525 FAIR RD STE 105A, STATESBORO, GA 30458-6118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003208278C
—
GA
Enumeration date
10/18/2024
Last updated
05/14/2025
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