SOUTH GEORGIA PHYSICAL MEDICINE AND REHABILITATION (NPI# 1225257132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225257132 |
| Entity Type | Organization |
| Organization Name | SOUTH GEORGIA PHYSICAL MEDICINE AND REHABILITATION |
| Practice Address |
114 Mimosa Dr Thomasville GA 31792-6677 |
| Mailing Address |
Po Box 1053 Thomasville GA 31799-1053 |
| Practice Telephone | 2292269412 |
| Mailing Telephone | 2292269412 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. LEAH M SAUNDERS (OFFICE MANAGER) |
| Authorized Official Telephone | 2292269412 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 041159 | GA | Other Service Providers |
| Street Address |
114 MIMOSA DR |
| City | THOMASVILLE |
| State | GA |
| Zip Code | 31792-6677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295798320 | Wayne L Bakotic | Pathology | 114 Mimosa Dr, Suite C, Thomasville, GA 31792-6677 | 2006-04-10 |
| 1730564998 | Archbold Medical Group, Inc | Psychiatry & Neurology | 114 Mimosa Dr, Suite C, Thomasville, GA 31792-6677 | 2015-07-29 |
| 1902932593 | Jemeka S Christian | Physician Assistant | 114 Mimosa Dr, Jdamh -- Apogee Medical Group, Thomasville, GA 31792-5739 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245739879 | Georgia Pines Community Service Board | Community/Behavioral Health | 407 Cloverdale Drive, Thomasville, GA 31792 | 2018-02-09 |
| 1932613551 | Diana Diaz | Physician Assistant | 2705 E Pinetree Blvd Ste A, Thomasville, GA 31792 | 2017-11-17 |
| 1194249425 | Bobbie Frazier | Contractor | 400 Cloverdale Dr, Thomasville, GA 31792 | 2017-07-28 |
| 1598132292 | Southern Scripts, LLC | Pharmacy | 501 Gordon Avenue, Thomasville, GA 31792 | 2015-08-28 |
| 1508248915 | Elizabeth Nicole Keen | Behavioral Analyst | 121 Covington Ave Apt 9, Thomasville, GA 31792 | 2015-06-22 |
| 1417341579 | Sheila L Stanley | Counselor | 301 Summercreek Cove, Thomasville, GA 31792 | 2015-03-26 |
| 1457749301 | Ashley Lamb | Speech-Language Pathologist | 1203 East Jackson Street, Thomasville, GA 31792 | 2014-12-30 |
| 1831403880 | Somnoquest | Durable Medical Equipment & Medical Supplies | 556 Hall Road, Thomasville, GA 31792 | 2010-08-02 |
| 1508000183 | Kashyap B Choksi | Internal Medicine | 100 Mimosa Drive 2nd Floor, Thomasville, GA 31792 | 2009-04-27 |
| 1205008786 | Mark J Glaccum | Chiropractor | 415 Gordon Avenue, Thomasville, GA 31792 | 2008-03-25 |
| Find all providers in zip 31792 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538346366 | Ent Associates of South West Ga | Specialist | 301 W Hansell St, 3rd Floor, Thomasville, GA 31792-6649 | 2008-01-23 |
| 1295805570 | G. Courtney Houston | Specialist | 416 Gordon Ave, Thomasville, GA 31792-6644 | 2006-11-08 |
| 1124197397 | South Georgia Laser Vein Center | Specialist | 903 S Broad St, Thomasville, GA 31792-6114 | 2006-11-06 |
| 1780620617 | Medventures,llc | Specialist | 524 Turner St, Thomasville, NC 27360-2646 | 2006-06-21 |
| 1962481226 | Alan S Waller | Specialist | 100 Mimosa Drive, Thomasville, GA 31792 | 2006-01-13 |
| 1598744542 | Oscar D. Jackson Jr. | Specialist | 805 S Hansell St, Thomasville, GA 31792-5560 | 2006-01-10 |
| 1245218361 | Joseph S. Novak Jr. | Specialist | 918 S Broad St, Thomasville, GA 31792-6198 | 2006-01-09 |
| 1770032831 | Southern Vascular Speciaists | Specialist | 505 Gordon Ave, Thomasville, GA 31792-6645 | 2016-09-29 |
| 1750750741 | Abraham Infectious Disease Associates LLC | Specialist | 2024 E Pinetree Blvd Ste H, Thomasville, GA 31792-5391 | 2015-09-19 |
| 1609215680 | Archbold Medical Group | Specialist | 706 S Broad St, Thomasville, GA 31792-6107 | 2013-06-23 |
| Find all providers in THOMASVILLE | ||||
| City | THOMASVILLE |
| Zip Code | 31792 |
Please comment or provide details below to improve the information on SOUTH GEORGIA PHYSICAL MEDICINE AND REHABILITATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.