Balaji Medical Practice, LLC Dba Clinch Medical Practice

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

059320 Issued in GA

Legal business name

BALAJI MEDICAL PRACTICE, LLC DBA CLINCH MEDICAL PRACTICE

Practice address

360 Courtland Ave
Homerville, GA 31634-2675

Phone

(912) 487-5053

NPI assigned

Aug 12, 2008

Last updated

Aug 12, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cindi B Stalvey

Title

Office Manager

Phone

(912) 487-5053

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1124274923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 COURTLAND AVE",
            "city": "HOMERVILLE",
            "state": "GA",
            "postal_code": "316342675",
            "telephone_number": "912-487-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 COURTLAND AVE",
            "city": "HOMERVILLE",
            "state": "GA",
            "postal_code": "316342675",
            "telephone_number": "912-487-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALAJI MEDICAL PRACTICE, LLC DBA CLINCH MEDICAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "STALVEY",
        "authorized_official_first_name": "CINDI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-487-5053"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "059320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Homerville, GA
• Providers in Homerville, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.