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General NPI Number Information
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NPI Number | 1538191580
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Entity Type | Organization
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Legal Business Name | PALMER CLINIC PC
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 131C VICTORY DRIVE
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City | SWAINSBORO
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State | GA
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Zip | 30401
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Country | US
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Telephone | 478-289-0007
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Fax | 478-289-0067
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Provider Business Mailing Address
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Address Line | PO BOX 4048
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City | MACON
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State | GA
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Zip | 31208-4048
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Country | US
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Telephone | 478-477-4818
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Fax | 478-474-5553
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY J PALMER
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Credential | DO
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Telephone | 478-289-0007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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