Organization
DOERUN PRIMARY CARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAYSHREE BHAVNANI (CFO)
(229) 891-9131
Entity
Organization
Contact information
Practice address
204 N BROAD ST, DOERUN, GA 31744
(229) 985-3320
(229) 890-1282
Mailing address
PO BOX 2876, MOULTRIE, GA 31776-2876
(229) 891-9131
(229) 891-9130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/07/2023
Last updated
07/28/2023
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