Organization
FAMILY CARE GROUP OF THOMSON, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARYL C WILEY MD (PRESIDENT)
(706) 595-1090
Entity
Organization
Contact information
Practice address
315 FLUKER ST, THOMSON, GA 30824-2108
(706) 595-1090
(706) 595-6010
Mailing address
315 FLUKER ST, THOMSON, GA 30824-2108
(706) 595-1090
(706) 595-6010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
032327
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP4411
MEDICARE GROUP NUMBER
GA
Enumeration date
10/15/2007
Last updated
03/03/2015
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