Organization
SOUTH GEORGIA MEDICAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHI BRUCH (ADMINISTRATOR)
(229) 244-4720
Entity
Organization
Contact information
Practice address
410 CONNELL RD, VALDOSTA, GA 31602-1407
(229) 244-4720
Mailing address
410 CONNELL RD, VALDOSTA, GA 31602-1407
(229) 244-4720
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300022100A
—
GA
Enumeration date
06/19/2006
Last updated
03/14/2014
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