| Hospital Authority Of Liberty County | |
|
455 S.main Street Ste 104 Hinesville GA 31313 | |
| (912) 876-5644 | |
| (912) 408-3457 |
| Full Name | Hospital Authority Of Liberty County |
|---|---|
| Speciality | Family Medicine |
| Location | 455 S.main Street Ste 104, Hinesville, Georgia |
| Authorized Official Name and Position | Derek Rozier (CFO) |
| Authorized Official Contact | 9123699427 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hospital Authority Of Liberty County 455 S Main Street Suite 104 Hinesville GA 31313-4354 Ph: (912) 876-5644 | Hospital Authority Of Liberty County 455 S.main Street Ste 104 Hinesville GA 31313 Ph: (912) 876-5644 |
| NPI Number | 1356636534 |
|---|---|
| Provider Enumeration Date | 06/15/2011 |
| Last Update Date | 01/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356636534 | NPI | - | NPPES |
| 065972 | Other | GA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 065972 (Georgia) | Primary |
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