Healthcare Provider Details

I. General information

NPI: 1164151379
Provider Name (Legal Business Name): JEFFERSON COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 US HIGHWAY 1 N
LOUISVILLE GA
30434-5213
US

IV. Provider business mailing address

PO BOX 306
LOUISVILLE GA
30434-0306
US

V. Phone/Fax

Practice location:
  • Phone: 478-625-3716
  • Fax: 478-625-8201
Mailing address:
  • Phone: 478-625-3716
  • Fax: 478-625-8201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: LEE ANN DONOHUE
Title or Position: DISTRICT HEALTH DIRECTOR
Credential: MD
Phone: 706-825-6914