Organization
OH CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANG WAN OH M.D. (PHYSICIAN)
(912) 557-4315
Entity
Organization
Contact information
Practice address
257 S MAIN ST, REIDSVILLE, GA 30453-4605
(912) 557-4315
(912) 557-3338
Mailing address
PO BOX 519, REIDSVILLE, GA 30453-0519
(912) 557-4315
(812) 557-3338
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
16117
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00012317A
—
GA
Enumeration date
09/27/2012
Last updated
09/27/2012
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