| Jimmy Diaz Md Pc | |
|
130 N Gross Rd Suite 202 Kingsland GA 31548 | |
| (912) 729-6606 | |
| (912) 729-1214 |
| Full Name | Jimmy Diaz Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 130 N Gross Rd, Kingsland, Georgia |
| Authorized Official Name and Position | Jimmy Diaz (PRESIDENT) |
| Authorized Official Contact | 9127296606 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jimmy Diaz Md Pc 130 N Gross Rd Suite 202 Kingsland GA 31548 Ph: (912) 729-6606 | Jimmy Diaz Md Pc 130 N Gross Rd Suite 202 Kingsland GA 31548 Ph: (912) 729-6606 |
| NPI Number | 1649479536 |
|---|---|
| Provider Enumeration Date | 07/12/2007 |
| Last Update Date | 08/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649479536 | NPI | - | NPPES |
| 000320581E | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 26097 (Georgia) | Primary |
| 363AM0700X | Physician Assistant - Medical | (Georgia) | Secondary |
Willis R Keene Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 N Gross Rd, Suite 205, Kingsland, GA 31548 Phone: 912-729-7332 Fax: 912-729-4307 | |
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