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General NPI Number Information
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NPI Number | 1790427268
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Entity Type | Organization
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Legal Business Name | YOUR CHOICE HEALTHCARE- BAXLEY, P.C
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 05/17/2024
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Provider Practice Location Address
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Address Line | 388 S MAIN ST
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City | BAXLEY
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State | GA
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Zip | 31513-0104
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Country | US
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Telephone | 912-705-9680
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Fax | 912-705-0531
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Provider Business Mailing Address
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Address Line | 388 S MAIN ST
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City | BAXLEY
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State | GA
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Zip | 31513-0104
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Country | US
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Telephone | 912-705-9680
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Fax | 912-705-0531
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Authorized Official
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Title or Position | OWNER
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Name | GREG LEE WILLIAMS
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Credential | FNP
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Telephone | 912-705-9680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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