Organization
MOULTRIE INTERNAL MEDICINE ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA LAMON RN (OFFICE MANAGER)
(229) 985-5200
Entity
Organization
Contact information
Practice address
320 SUNSET CIR, MOULTRIE, GA 31768-6924
(229) 985-5200
Mailing address
320 SUNSET CIR, MOULTRIE, GA 31768-6924
(229) 985-5200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21172
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00220349C
—
GA
Enumeration date
02/07/2007
Last updated
05/04/2022
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