Organization
FT GAINES MEDICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDOLLATIF S GHIATHI DO (OWNER)
(334) 793-8087
Entity
Organization
Contact information
Practice address
106 HARTFORD RD E, FORT GAINES, GA 39851-3638
(229) 768-2633
(229) 768-2263
Mailing address
PO BOX 489, CUTHBERT, GA 39840-0489
(229) 768-2633
(229) 768-2263
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/09/2007
Last updated
07/11/2008
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