| Smith & Purvis Family Practice Clinic, Pc | |
| 
					412 Northside Dr E Suite 200 Statesboro GA 30458-4802  | |
| (912) 764-9684 | |
| (912) 489-8676 | 
| Full Name | Smith & Purvis Family Practice Clinic, Pc | 
|---|---|
| Speciality | Family Medicine | 
| Location | 412 Northside Dr E, Statesboro, Georgia | 
| Authorized Official Name and Position | Teri S Daigneault (MEDICAL CODER) | 
| Authorized Official Contact | 9127641039 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Smith & Purvis Family Practice Clinic, Pc 412 Northside Dr E Suite 200 Statesboro GA 30458-4802 Ph: (912) 764-9684  | Smith & Purvis Family Practice Clinic, Pc 412 Northside Dr E Suite 200 Statesboro GA 30458-4802 Ph: (912) 764-9684  | 
| NPI Number | 1043384183 | 
|---|---|
| Provider Enumeration Date | 11/20/2006 | 
| Last Update Date | 08/22/2020 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1043384183 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | 029847 (Georgia) | Secondary | 
| 207Q00000X | Family Medicine | 048703 (Georgia) | Secondary | 
| 207Q00000X | Family Medicine | 18745 (Georgia) | Primary | 
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