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NPI Code Detail

MEDICARE: SOUTHWESTERN EMERGENCY PHYSICIANS PC

MEDICARE: SOUTHWESTERN EMERGENCY PHYSICIANS PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianGA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CK5608OTHERGARAILROAD MEDICARE

General Provider Information

NPI Number : 1356336986
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWESTERN EMERGENCY PHYSICIANS PC
Provider Business Mailing Address
First Line : PO BOX 408
Second Line :
City : ALBANY
State : GA
Zip : 31702-0408
Country : US
Telephone Number : 205-437-6098
Fax Number : 205-437-5998
Provider Business Practice Location Address
First Line : 417 W 3RD AVE
Second Line :
City : ALBANY
State : GA
Zip : 31701-1943
Country : US
Telephone Number : 229-312-4155
Fax Number : 229-312-4144
Authorized Official
Title or Position : VICE PRESIDENT
Name : DR. ALFRED L WOODARD
Credential : MD
Telephone Number : 229-317-2207
Provider Enumeration Date : 09/20/2005
Last Update Date : 04/20/2008

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1184623399 — DR. ELLEN KING PHARM.D., MBA, FACHE
Practice Location Address:
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ALBANY, GA
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Practice Fax:
1093700262 — MRS. DEBORAH J TRAMMELL MD
Practice Location Address:
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ALBANY, GA
31701-1943
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Practice Fax:
1194710830 — DR. ALFRED LEE WOODARD MD
Practice Location Address:
417 W 3RD AVE
ALBANY, GA
31701-1943
Practice Phone: 229-317-2207
Practice Fax: 229-317-2214

Directions to “SOUTHWESTERN EMERGENCY PHYSICIANS PC ” Practice Location

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