| Kids Health | |
|
303 Shirley Ave Ste B Douglas GA 31533 | |
| (912) 384-2474 | |
| (912) 384-4995 |
| Full Name | Kids Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 303 Shirley Ave, Douglas, Georgia |
| Authorized Official Name and Position | Robert B Tucker (CEO) |
| Authorized Official Contact | 2294689166 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids Health 204 E 4th St P O Box 749 Ocilla GA 31774-1539 Ph: (229) 468-9166 | Kids Health 303 Shirley Ave Ste B Douglas GA 31533 Ph: (912) 384-2474 |
| NPI Number | 1063840296 |
|---|---|
| Provider Enumeration Date | 10/25/2013 |
| Last Update Date | 04/03/2025 |
| Certification Date | 04/03/2025 |
| Medicare PECOS PAC ID | 1951395920 |
|---|---|
| Medicare Enrollment ID | O20070629000611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063840296 | NPI | - | NPPES |
| 003140047A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
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