Organization
SOUTHERN HEALTHCARE SYSTEMS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN DAVID WADE DO (PRESIDENT)
(770) 235-3301
Entity
Organization
Contact information
Practice address
380 N CHURCH ST, HOMERVILLE, GA 31634-2452
(912) 487-2345
Mailing address
380 N CHURCH ST, HOMERVILLE, GA 31634-2452
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
66666
GA
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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