Baxley Medical Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

057979 Issued in GA

Legal business name

BAXLEY MEDICAL CLINIC, LLC

Practice address

331 S Main St
Baxley, GA 31513-0109

Phone

(912) 367-9112

Fax

(912) 367-6233

NPI assigned

Dec 27, 2007

Last updated

Apr 15, 2010By 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

Dr. James Adrian Graham, M.D.

Title

Owner

Phone

(912) 367-9112

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271289600000",
    "number": "1174707103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 S MAIN ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130109",
            "telephone_number": "912-367-9112",
            "fax_number": "912-367-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 S MAIN ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130109",
            "telephone_number": "912-367-9112",
            "fax_number": "912-367-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXLEY MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2010-04-15",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ADRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-367-9112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "057979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "662027563E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barjinder Singh,MD (south georgia oncology hematology center)
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• Mark Tollison Barnes, R.PH.
• Jessie Marguriette Bass, NP-C
• Baxley Eyecare Center
• Baxley Primary Care, PC
• Baxley Wellness Pharmacy Inc.
• Baxley Wellness Pharmacy Inc. Long-Term Care (Baxley Wellness Pharmacy Inc)
• Martha D Beecher, NP
• Robert E Bennett Jr.

• Family Medicine Physician in Baxley, GA
• Providers in Baxley, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; 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.