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General NPI Number Information
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NPI Number | 1972785368
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Entity Type | Organization
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Legal Business Name | ISLAND MEDICAL, P.C.
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Dates
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Enumeration Date | 11/28/2007
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Last Update Date | 03/31/2010
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Provider Practice Location Address
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Address Line | 2500 STARLING STREET SUITE 402
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City | BRUNSWICK
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State | GA
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Zip | 31520-4219
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Country | US
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Telephone | 912-554-0111
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Fax | 912-554-0830
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Provider Business Mailing Address
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Address Line | 2500 STARLING STREET SUITE 402
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City | BRUNSWICK
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State | GA
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Zip | 31520-4219
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Country | US
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Telephone | 912-554-0111
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Fax | 912-554-0830
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Authorized Official
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Title or Position | OWNER
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Name | DR. MALCOLM G WRIGHT
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Credential |
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Telephone | 912-554-0111
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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 | GA
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