Caron Medical Clinic, PC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

046377 Issued in GA

Legal business name

CARON MEDICAL CLINIC, PC

Practice address

11638 Highway 27
Suite 8
Summerville, GA 30747-8514

Phone

(706) 857-2133

Fax

(706) 857-2139

NPI assigned

Mar 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Douglas E Caron, MD

Title

President

Phone

(706) 857-2133

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1295905073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11638 HIGHWAY 27",
            "address_2": "SUITE 8",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307478514",
            "telephone_number": "706-857-2133",
            "fax_number": "706-857-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11638 HIGHWAY 27",
            "address_2": "SUITE 8",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307478514",
            "telephone_number": "706-857-2133",
            "fax_number": "706-857-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARON MEDICAL CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "CARON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-857-2133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": "GA",
            "license": "046377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Summerville, GA
• Community Health Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.