Organization
QUINTON W WELDON ESTATE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA M WELDON EXECUTOR/OWNER (EXECUTOR)
(229) 928-3920
Entity
Organization
Contact information
Practice address
100 PLANTATION RIDGE DRIVE, SUITE D, AMERICUS, GA 31709
(229) 928-3920
(229) 928-3921
Mailing address
P.O. BOX 546, AMERICUS, GA 31709
(229) 928-3920
(229) 928-3921
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
056786
GA
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/28/2008
Last updated
04/23/2015
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