Organization
SOUTHWEST MEDICAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OBINNA B UBANI-EBERE PH.D. (PRACTICE ADMINISTRATOR)
(706) 553-3270
Entity
Organization
Contact information
Practice address
64 JONES MILL ROAD, SUITE B BOX 517, WOODBURY, GA 30293
(706) 553-3270
Mailing address
PO BOX 517, 64B JONES MILL ROAD, WOODBURY, GA 30293
(706) 553-3270
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042618
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000719947AG
—
GA
Enumeration date
05/04/2007
Last updated
02/12/2010
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