| Doerun Primary Care Clinic LLC | |
|
204 N Broad St Doerun GA 31744 | |
| (229) 985-3320 | |
| (229) 890-1282 |
| Full Name | Doerun Primary Care Clinic LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 204 N Broad St, Doerun, Georgia |
| Authorized Official Name and Position | Jayshree Bhavnani (CFO) |
| Authorized Official Contact | 2298919131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Doerun Primary Care Clinic LLC Po Box 2876 Moultrie GA 31776-2876 Ph: (229) 891-9131 | Doerun Primary Care Clinic LLC 204 N Broad St Doerun GA 31744 Ph: (229) 985-3320 |
| NPI Number | 1891480653 |
|---|---|
| Provider Enumeration Date | 04/07/2023 |
| Last Update Date | 07/28/2023 |
| Certification Date | 07/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891480653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
Doerun Family Medicine Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 128 West Broad Ave, Doerun, GA 31744 Phone: 229-891-9131 Fax: 229-891-9079 |