Organization
26KC CENTER FOR FAMILY MEDICINE
Active
Organization
26KC CENTER FOR FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNEDY KELECHI OKERE MD (MEDICAL DIRECTOR)
(912) 826-3373
Entity
Organization
Contact information
Practice address
800 TOWNE PARK DR, SUIT 400,, RINCON, GA 31326-5156
(912) 826-3373
Mailing address
800 TOWNE PARK DR, SUIT 400, P.O .BOX 1599, RINCON, GA 31326-5156
(912) 308-8799
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
50331
GA
261QP2300X
Primary Care Clinic/Center
50331
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000923062E
—
GA
Enumeration date
10/20/2007
Last updated
10/25/2009
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