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General NPI Number Information
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NPI Number | 1982910048
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Entity Type | Organization
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Legal Business Name | AMELIA MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 08/27/2010
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1481 HWY 40 E
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City | KINGSLAND
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State | GA
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Zip | 31548-6507
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Country | US
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Telephone | 912-729-2821
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Fax | 912-729-2823
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Provider Business Mailing Address
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Address Line | 1481 HWY 40 E
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City | KINGSLAND
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State | GA
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Zip | 31548-6507
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Country | US
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Telephone | 912-729-2821
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Fax | 912-729-2823
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL J. MATRICIA
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Credential | D.O.
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Telephone | 912-729-2821
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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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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 031289
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License Number State | GA
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