Organization
FAMILY PRACTICE HEALTHCARE CLINIC/ URGENT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDMUND MATT WRIGHT SR. MD (MD)
(229) 868-2831
Entity
Organization
Contact information
Practice address
10 NORTH 3RD AVE, MCRAE, GA 31055-4941
(229) 868-2831
(229) 520-3068
Mailing address
10 NORTH 3RD AVE, MCRAE, GA 31055-4941
(229) 868-2831
(229) 520-3068
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
037111
GA
261QP2300X
Primary Care Clinic/Center
RN115997
GA
261QU0200X
Urgent Care Clinic/Center
037111
GA
261QU0200X
Urgent Care Clinic/Center
RN115997
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000539283J
—
GA
01
—
RN115997
LICENSE NUMBER
GA
Enumeration date
06/30/2009
Last updated
03/28/2012
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