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General NPI Number Information
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NPI Number | 1558525931
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Entity Type | Organization
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Legal Business Name | SOUZA FAMILY HEALTH & URGENT CARE CENTER, LLC
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 04/08/2014
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Provider Practice Location Address
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Address Line | 1110 HILLCREST PKWY
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City | DUBLIN
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State | GA
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Zip | 31021-3687
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Country | US
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Telephone | 478-304-1268
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16100
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City | DUBLIN
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State | GA
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Zip | 31040-6100
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Country | US
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Telephone | 478-304-1268
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN SOUZA
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Credential | M.D.
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Telephone | 478-304-1268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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