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Primedoc of Brunswick Inc

Organization Active NPI Internal Medicine Physician · Brunswick, GA

NPI 1528298536 · NPPES record last updated Jul 24, 2009

Key facts

NPI
1528298536
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
PRIMEDOC OF BRUNSWICK INC
Practice address
2415 Parkwood Dr
Brunswick, GA 31520-4722
Phone
(912) 466-7000
Fax
(912) 466-7026
NPI assigned
Jul 24, 2009
Organization subpart
No

Authorized official

Name
Robert J Reynolds, MD
Title
President/Owner
Phone
(828) 210-3260

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207R00000X Yes

Addresses

Primary practice location

2415 Parkwood Dr
Brunswick, GA 31520-4722

Mailing address

PO Box 602287
Charlotte, NC 28260-2287
Phone (828) 210-3260

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 24, 2009.

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248393600000",
    "number": "1528298536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602287",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602287",
            "telephone_number": "828-210-3260",
            "fax_number": "828-255-7623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 PARKWOOD DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204722",
            "telephone_number": "912-466-7000",
            "fax_number": "912-466-7026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMEDOC OF BRUNSWICK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-24",
        "last_updated": "2009-07-24",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "828-210-3260",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

All providers in Brunswick, GA · Internal Medicine Physician in Georgia

Sources for this page

Verify at the official NPI Registry.