Organization
SUPREME INTERNAL MEDICINE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAMILTON O EMOKPAE M.D. (PHYSICIAN)
(912) 243-9080
Entity
Organization
Contact information
Practice address
1207 MERCHANT WAY, SUITE 201, STATESBORO, GA 30458-0861
(912) 243-9080
(912) 243-9084
Mailing address
1207 MERCHANT WAY, SUITE 201, STATESBORO, GA 30458
(912) 243-9080
(912) 243-9084
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
68726
GA
Other
Enumeration date
05/24/2013
Last updated
05/24/2013
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