| Habersham Family Medicine | |
|
865 Austin Dr Demorest GA 30535-4513 | |
| (706) 754-8811 | |
| (706) 754-8822 |
| Full Name | Habersham Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 865 Austin Dr, Demorest, Georgia |
| Authorized Official Name and Position | Donald L Fordham (OWNER) |
| Authorized Official Contact | 7067548811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Habersham Family Medicine Po Box 308 Demorest GA 30535-0308 Ph: (706) 754-8811 | Habersham Family Medicine 865 Austin Dr Demorest GA 30535-4513 Ph: (706) 754-8811 |
| NPI Number | 1326022328 |
|---|---|
| Provider Enumeration Date | 12/02/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8123295987 |
|---|---|
| Medicare Enrollment ID | O20120118000769 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326022328 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 044718 (Georgia) | Primary |
| Provider Name | Donald L Fordham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477537470 PECOS PAC ID: 1658383831 Enrollment ID: I20060707000325 |
| Provider Name | Camden L Randels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194062505 PECOS PAC ID: 3173777554 Enrollment ID: I20220729002098 |
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Nancy M Watson Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 676 441 Historic Hwy N, Demorest, GA 30535 Phone: 706-754-8884 | |
Habersham Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 590 Historic Hwy 441 N, Demorest, GA 30535 Phone: 706-754-5511 Fax: 706-754-5577 | |
Family Practice Of Habersham Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 590 Historic Hwy 441 N, Demorest, GA 30535 Phone: 706-754-5511 Fax: 706-754-5577 | |
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