Organization
HAZLEHURST FAMILY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. UMAMAHESWARI JONNALAGADDA MD (OFFICER)
(912) 383-9300
Entity
Organization
Contact information
Practice address
906 BRYAN ST W, DOUGLAS, GA 31533-2330
(912) 383-9300
(912) 383-9292
Mailing address
906 BRYAN ST W, DOUGLAS, GA 31533-2330
(912) 383-9300
(912) 383-9292
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
GA042299
GA
Other
Enumeration date
11/14/2007
Last updated
11/14/2007
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