MEDICARE: CAIRO MEDICAL CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	035312	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861572067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAIRO MEDICAL CARE, LLC

Provider Business Mailing Address
First Line	:	1178 5TH ST SE
Second Line	:
City	:	CAIRO
State	:	GA
Zip	:	39828-3141
Country	:	US
Telephone Number	:	229-377-2002
Fax Number	:	229-377-0930

Provider Business Practice Location Address
First Line	:	1178 5TH ST SE
Second Line	:
City	:	CAIRO
State	:	GA
Zip	:	39828-3141
Country	:	US
Telephone Number	:	229-377-2002
Fax Number	:	229-377-0930

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GARLAND ASHLEY REGISTER JR.
Credential	:	M.D.
Telephone Number	:	229-377-2002

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	03/25/2010

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Directions to “CAIRO MEDICAL CARE, LLC ” Practice Location

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