Herbert F. Congram, D.C.
Individual provider Active NPI Chiropractor · Fitzgerald, GA
NPI 1619087830 · NPPES record last updated Jan 14, 2009
Key facts
- NPI
- 1619087830
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CHIR008315 (GA)
- Practice address
- 219 Haile Booker Rd
Fitzgerald, GA 31750-8725 - Phone
- (229) 423-0550
- Fax
- (229) 424-0923
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1487 | MA | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIR008315 | GA | Yes |
Addresses
Primary practice location
219 Haile Booker Rd
Fitzgerald, GA 31750-8725
Mailing address
219 Haile Booker Rd
Fitzgerald, GA 31750-8725
Phone (229) 423-0550
Other names
- Dr. Herb. F. Congram
Other providers in Fitzgerald, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2009. 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.