| Norman Park Family Medicine Clinic Llc | |
|
139 East Broad Street Norman Park GA 31771 | |
| (229) 769-3500 | |
| (229) 769-3501 |
| Full Name | Norman Park Family Medicine Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 139 East Broad Street, Norman Park, Georgia |
| Authorized Official Name and Position | James L Matney (CEO) |
| Authorized Official Contact | 2299853420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Norman Park Family Medicine Clinic Llc Po Box 2876 Moultrie GA 31776-2876 Ph: (229) 769-3500 | Norman Park Family Medicine Clinic Llc 139 East Broad Street Norman Park GA 31771 Ph: (229) 769-3500 |
| NPI Number | 1518398049 |
|---|---|
| Provider Enumeration Date | 12/10/2013 |
| Last Update Date | 09/04/2025 |
| Medicare PECOS PAC ID | 4082833546 |
|---|---|
| Medicare Enrollment ID | O20140915001944 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518398049 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Georgia) | Primary |
| Provider Name | Hope C Littleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881765154 PECOS PAC ID: 3476534074 Enrollment ID: I20040528000676 |
| Provider Name | Robert O Spruill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609808179 PECOS PAC ID: 6507967866 Enrollment ID: I20070731000297 |
| Provider Name | Justin A Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790707925 PECOS PAC ID: 5294739033 Enrollment ID: I20080429000440 |
| Provider Name | Gary W Swartzentruber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083937908 PECOS PAC ID: 7719016575 Enrollment ID: I20100603000832 |
| Provider Name | Carolyn Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780092684 PECOS PAC ID: 3577782036 Enrollment ID: I20140915002087 |
| Provider Name | Mary Catherine Duskin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982124285 PECOS PAC ID: 3870918931 Enrollment ID: I20200806000906 |