Organization
GEORGIA SOUTHERN UNIVERSITY
Active
Other names
Georgia Southern University Athletics
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL FERGUSON (DIRECTOR)
(912) 536-2239
Entity
Organization
Contact information
Practice address
590 HERTY DRIVE, ROOM 1216, STATESBORO, GA 30458
(912) 478-7581
(912) 478-7690
Mailing address
590 HERTY DRIVE, ROOM 1216, STATESBORO, GA 30458
(912) 478-7581
(912) 478-7690
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/06/2012
Last updated
11/06/2012
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