Organization
ICH PHYSICIAN GROUP
Active
Other names
Willacoochee Clinic, IRWIN COUNTY HOSPITAL AUTHORITY
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL CARVER (CFO)
(229) 468-3846
Entity
Organization
Contact information
Practice address
134 FLEETWOOD AVE E, WILLACOOCHEE, GA 31650-2730
(912) 534-5142
(912) 534-6120
Mailing address
710 N IRWIN AVE, OCILLA, GA 31774-5011
(229) 468-3800
(229) 468-9991
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/25/2014
Last updated
02/27/2025
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