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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