Healthcare Provider Details

I. General information

NPI: 1659282713
Provider Name (Legal Business Name): BROOKS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 W SCREVEN ST
QUITMAN GA
31643-1922
US

IV. Provider business mailing address

606 W SCREVEN ST
QUITMAN GA
31643-1922
US

V. Phone/Fax

Practice location:
  • Phone: 229-263-8888
  • Fax:
Mailing address:
  • Phone: 229-263-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: LOREN J RIALS
Title or Position: CFO
Credential:
Phone: 229-228-2853