Organization
HINESVILLE WOMEN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLIPHANE W MCLEOD M.D. (OWNER)
(912) 373-7035
Entity
Organization
Contact information
Practice address
4540 E OGLETHORPE HWY, SUITE B, HINESVILLE, GA 31313-1445
(912) 373-7035
(912) 369-2482
Mailing address
4540 E OGLETHORPE HWY, SUITE B, HINESVILLE, GA 31313-1445
(912) 373-7035
(912) 369-2482
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
GA029212
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000336102A
—
GA
Enumeration date
08/22/2011
Last updated
08/22/2011
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