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Organization

TOTS TO TEENS MEDICAL CENTER

Active
Other names
Tots To Teens Medical Ctr
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JO E. SMITH CMM (PRACTICE ADMINISTRATOR)
(912) 537-9991
Entity
Organization

Contact information

Practice address
303 HARRIS INDUSTRIAL BLVD., SUITE 1, VIDALIA, GA 30474
(912) 537-9991
(912) 537-9975
Mailing address
PO BOX 569, VIDALIA, GA 30475
(912) 537-9991
(912) 537-9975

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
12/04/2006
Last updated
02/09/2009
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