Debra L Crawley-Mataosky, MD
Individual provider Active NPI Family Medicine Physician · Swainsboro, GA
NPI 1467445593 · NPPES record last updated Nov 7, 2007
Key facts
- NPI
- 1467445593
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 033573 (GA)
- Practice address
- 316 N Main St
Swainsboro, GA 30401-3535 - Phone
- (478) 237-2638
- Fax
- (478) 237-9138
- NPI assigned
- Aug 24, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 033573 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-County Health System, Inc. | Past | Accepting new patients | |
| East Georgia Healthcare Center, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 033573 | GA | Yes |
Addresses
Primary practice location
316 N Main St
Swainsboro, GA 30401-3535
Mailing address
PO Box 807
Swainsboro, GA 30401-0807
Phone (478) 237-2638
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111814 | Other | GA | UGS-WARRENTON |
| 111889 | Other | GA | UGS-SOPERTON |
| 08BDFLS | Other | MEDICARE FFS | |
| 111811 | Other | GA | UGS-SPARTA |
| 111830 | Other | GA | UGS-SWAINSBORO |
| 111812 | Other | GA | UGS-GIBSON |
| 111813 | Other | GA | UGS-CRAWFORDVILLE |
| 111887 | Other | GA | UGS REIDSVILLE |
Other providers in Swainsboro, GA
- Community Service Board of Middle Georgia
- Community Service Board of Middle Georgia
- William F Connor
- Kimberly Page Cooper
- Janet Costley
- David W Crooke
- Crossroads Wellness PC
- Lydia Lee Daley
- Suffearria Makia Daniels-Ellison
- Debbie Jean Davis
All providers in Swainsboro, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.