Michael W Clifford, MD

Individual provider Active NPI General Practice Physician · Colquitt, GA

NPI 1508800475 · NPPES record last updated Jun 17, 2016

Key facts

NPI
1508800475
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
037508 (GA)
Practice address
208 N Cuthbert St
Miller County Medical Center
Colquitt, GA 39837-3517
Phone
(229) 758-3344
Fax
(229) 758-6622
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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

LicenseStateTypeSpecialty
037508GAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Cardiology Clinic Inc. Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 037508 GA Yes

Addresses

Primary practice location

208 N Cuthbert St
Miller County Medical Center
Colquitt, GA 39837-3517

Mailing address

208 N Cuthbert St
Colquitt, GA 39837-3517
Phone (229) 758-3344

Other identifiers

IdentifierTypeStateIssuer
000579543CMedicaidGA

Other providers in Colquitt, GA

All providers in Colquitt, GA · General Practice Physician in Georgia

Sources for this page

Verify at the official NPI Registry.