DOERUN FAMILY MEDICINE CLINIC (NPI# 1992147573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992147573 |
| Entity Type | Organization |
| Organization Name | DOERUN FAMILY MEDICINE CLINIC |
| Practice Address |
128 West Broad Ave Doerun GA 31744 |
| Mailing Address |
Po Box 624 Doerun GA 31744-0624 |
| Practice Telephone | 2298919131 |
| Practice Fax Number | 2298919079 |
| Mailing Telephone | 2298919131 |
| Mailing Fax Number | 2298919079 |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2015-05-07 |
| Authorized Official Name | MR. WENDELL LARRY SIMS (CFO) |
| Authorized Official Telephone | 2299853420 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003157266A | 05 | |
| GA | MEDICARE PART A | 11-8911 | 01 |
| Street Address |
128 WEST BROAD AVE |
| City | DOERUN |
| State | GA |
| Zip Code | 31744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770920829 | Mildred A Thomas | Assisted Living Facility | 810 Se Moultrie Road, Doerun, GA 31744 | 2013-05-30 |
| 1962846600 | Highway To Heaven LLC | Assisted Living Facility | 152 Edge Road, Doerun, GA 31744 | 2013-04-24 |
| 1295009637 | Albany Vascular Specialtist Center, LLC | Family Medicine | 128 West Broad Avenue, Doerun, GA 31744 | 2012-03-02 |
| 1639138423 | The Apothecary Ltc | Pharmacy | 128 West Broad Ave., Doerun, GA 31744 | 2006-03-21 |
| 1780879957 | Doerun Healthcare L.L.C. | Nurse Practitioner | 217 West Broad Ave, Doerun, GA 31744-0459 | 2007-09-11 |
| 1225087083 | Apothecary Inc | Pharmacy | 130 W Broad Ave, Doerun, GA 31744-0490 | 2006-05-09 |
| 1720536766 | Wendy Hayes | Contractor | 922 S Fain St, Doerun, GA 31744-5010 | 2016-09-20 |
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437651924 | Amanda Mckenzie | Clinic/Center | Us Renal Care 657 Hemlock Street, Macon, GA 31206 | 2018-03-01 |
| 1518398049 | Norman Park Family Medicine Clinic | Clinic/Center | 139 East Broad Street, Norman Park, GA 31771 | 2013-12-10 |
| 1366784415 | Emanuel County Hospital Authority | Clinic/Center | 131a Victory Dr, Swainsboro, GA 30401-3234 | 2013-03-26 |
| 1306114004 | Lower Oconee Community Hospital, Inc | Clinic/Center | 421 W Robinson Dr, Mount Vernon, GA 30445-2935 | 2011-12-08 |
| 1013248962 | Southern Health Corp of Ellijay | Clinic/Center | 60 Old Highway 5 South, Ellijay, GA 30540-5436 | 2010-01-15 |
| 1427384353 | Union County Hospital Authority | Clinic/Center | 103 Church St Ste A, Hiawassee, GA 30546-3223 | 2009-10-28 |
| 1346574084 | Durall Capital Holdings, LLC | Clinic/Center | 59 Tipton Drive, Dahlonega, GA 30533 | 2009-09-29 |
| 1215260617 | Durall Capital Holdings, LLC | Clinic/Center | 35 Lumpkin Campground Road N, Dawsonville, GA 30534 | 2009-09-16 |
| 1376778001 | Phoebe Sumter Medical Center, Inc | Clinic/Center | 339 S Broad St, Ellaville, GA 31806-3304 | 2009-05-26 |
| 1720227895 | The Baxley and Appling County Hospital Authority | Clinic/Center | 105 E Tollison St, Suite D, Baxley, GA 31513-0149 | 2009-02-13 |
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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.