| Pooler Parkway Internal Medicine, LLC | |
|
143 Canal St Suite 100 Pooler GA 31322-6007 | |
| (912) 330-5149 | |
| Not Available |
| Full Name | Pooler Parkway Internal Medicine, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 143 Canal St, Pooler, Georgia |
| Authorized Official Name and Position | Patty Pierce (PRACTICE MANAGER) |
| Authorized Official Contact | 9123305143 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pooler Parkway Internal Medicine, LLC 143 Canal St Suite 100 Pooler GA 31322-6007 Ph: (912) 330-5149 | Pooler Parkway Internal Medicine, LLC 143 Canal St Suite 100 Pooler GA 31322-6007 Ph: (912) 330-5149 |
| NPI Number | 1376758581 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376758581 | NPI | - | NPPES |
| 1932129822 | Other | GA | MICHELLE L. WILSON, DO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 39698 (Georgia) | Primary |
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