SOUTHWEST MEDICAL CLINIC, INC (NPI# 1750593430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750593430 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST MEDICAL CLINIC, INC |
| Practice Address |
64 Jones Mill Road Suite B Box 517 Woodbury GA 30293 |
| Mailing Address |
Po Box 517 64b Jones Mill Road Woodbury GA 30293 |
| Practice Telephone | 7065533270 |
| Mailing Telephone | 7065533270 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2010-02-12 |
| Authorized Official Name | DR. OBINNA B UBANI-EBERE (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 7065533270 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 042618 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000719947AG | 05 |
| Street Address |
64 JONES MILL ROAD SUITE B BOX 517 |
| City | WOODBURY |
| State | GA |
| Zip Code | 30293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295705184 | Michael Wayne Akins | Pharmacist | 40 Forest Lane, Woodbury, GA 30293 | 2006-01-24 |
| 1972737633 | Audrey Denise Ross | Case Manager/Care Coordinator | 5760 Jones Mill Rd, Woodbury, GA 30293-2101 | 2009-05-11 |
| 1205282209 | Hillary Vickery | Speech-Language Pathologist | 356 Covered Bridge Rd, Woodbury, GA 30293-2348 | 2016-05-09 |
| 1538635255 | Timothy Peter Daniel | Nurse Practitioner | 64a Jones Mill Rd, Woodbury, GA 30293-2678 | 2018-10-20 |
| 1912564618 | Meriwether Healthcare, L.L.C. | Clinic/Center | 64a Jones Mill Rd, Woodbury, GA 30293-2678 | 2019-05-29 |
| 1881862944 | Merwiether Co Health Department | Public Health or Welfare | 18425 Main St, Woodbury, GA 30293-2933 | 2008-02-12 |
| 1710957014 | U-save-it Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 18126 Main St, Woodbury, GA 30293-2945 | 2006-01-26 |
| 1366900391 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 410 Dromedary St, Woodbury, GA 30293-3560 | 2019-03-08 |
| 1790850592 | Michelle S Womble Custer | Nurse Anesthetist, Certified Registered | 65 Waddell Rd, Woodbury, GA 30293-4008 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376143891 | Results-ast Jv, LLC | Physical Therapist | 324 Doolittle Road, Woodbury, TN 37190 | 2020-10-26 |
| 1841899150 | Sarah Nyandoro | Registered Nurse | 10635 Pond Curv, Woodbury, MN 55129-5810 | 2020-10-19 |
| 1538768916 | Shari Kohn | Psychologist | 20 Shadow Ln, Woodbury, NY 11797-2222 | 2020-10-18 |
| 1669079992 | Woodbury Surgery Center, LLC | Clinic/Center | 587 Bielenberg Dr Ste 100, Woodbury, MN 55125-4452 | 2020-10-09 |
| 1427655422 | Tara Tranguch | Naturopath | 74 Main Street North, Bldg 2 - Apt 204, Woodbury, CT 06798 | 2020-10-03 |
| 1780291245 | Meghan Kathleen Nilan | Dietitian, Registered | 7987 Drake Bay, Woodbury, MN 55125-1577 | 2020-09-29 |
| 1326655093 | Shane Michael Hamp | Social Worker | 1000 Radio Dr Ste 210, Woodbury, MN 55125-8444 | 2020-09-28 |
| 1578179727 | Natasha Ann Keller | Marriage & Family Therapist | 1802 Wooddale Dr Ste 101, Woodbury, MN 55125-2993 | 2020-09-22 |
| 1528674819 | Flourishing Roots Therapy LLC | Social Worker | 51 Sherman Hill Rd, Building A, Suite 202, Woodbury, CT 06798-0679 | 2020-09-22 |
| 1457967895 | Lisa Eisenbacher | Technician, Other | 731 Bielenberg Dr Ste 102-103, Woodbury, MN 55125-1700 | 2020-09-21 |
| Find all providers in WOODBURY | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811401128 | Pk Medical, Pllc | Internal Medicine | Excel At Woodbury, 8533 Jericho Turnpile, Woodbury, NY 11797-1804 | 2017-11-22 |
| 1962894089 | Soltani Medical PC | Internal Medicine | 11 Joyce Ct, Woodbury, NY 11797-2110 | 2015-02-26 |
| 1649600651 | Wei Yan Tan Physician. P.C. | Internal Medicine | 281 Syosset Woodbury Rd, Woodbury, NY 11797-1205 | 2013-11-13 |
| 1548602865 | Monica Bajracharya | Internal Medicine | 9373 Compass Pointe Rd, Woodbury, MN 55129 | 2013-07-28 |
| 1093079220 | Herbert Swarz | Internal Medicine | 20 Scuppo Rd, Woodbury, CT 06798-3811 | 2012-07-03 |
| 1366706723 | Zubin Arora | Internal Medicine | 237 Radio Dr #210, Woodbury, MN 55125-5805 | 2012-06-30 |
| 1184983272 | Fred Yale Lobovsky | Internal Medicine | 25 Lark Drive, Woodbury, NY 11797-3203 | 2012-05-09 |
| 1861763559 | Daniel Benjamin Goodman | Internal Medicine | 60 Davids Hill Rd, Woodbury, CT 06798-2113 | 2012-01-26 |
| 1912291873 | Tony George | Internal Medicine | 250 Plainview Rd, Woodbury, NY 11797-2807 | 2011-06-07 |
| 1073849444 | Ann Wendling | Internal Medicine | 6603 Crackleberry Trl, Woodbury, MN 55129-8404 | 2009-10-20 |
| Find all providers in WOODBURY | ||||
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| 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.