Healthcare Provider Details

I. General information

NPI: 1689684862
Provider Name (Legal Business Name): COUNTY OF JASPER HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 EATONTON ST
MONTICELLO GA
31064-1062
US

IV. Provider business mailing address

201 2ND ST STE 1100
MACON GA
31201-6328
US

V. Phone/Fax

Practice location:
  • Phone: 706-468-6850
  • Fax: 706-468-1422
Mailing address:
  • Phone: 478-297-5190
  • Fax: 478-751-6099

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: DANIELLE MCNAIR
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 478-751-6303