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General NPI Number Information
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NPI Number | 1659295236
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Entity Type | Organization
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Legal Business Name | DODGE IMMEDIATE HEALTH
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 829 PLAZA AVE
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City | EASTMAN
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State | GA
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Zip | 31023-6757
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Country | US
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Telephone | 478-448-8272
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Fax | 478-448-8273
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Provider Business Mailing Address
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Address Line | 829 PLAZA AVE
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City | EASTMAN
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State | GA
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Zip | 31023-6757
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Country | US
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Telephone | 478-448-8272
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Fax | 478-448-8273
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Authorized Official
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Title or Position | CFO
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Name | JAN HAMRICK
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Credential |
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Telephone | 478-448-8272
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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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