Crisp General Internal Medicine Inc
Organization Active NPI Medical Specialty Clinic/Center · Cordele, GA
NPI 1669632014 · NPPES record last updated Jun 10, 2008
Key facts
- NPI
- 1669632014
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medical Specialty Clinic/Center 261QM2500X
- License
- 060593 (GA)
- Legal business name
- CRISP GENERAL INTERNAL MEDICINE INC
- Practice address
- 416 E 4TH Ave Ste B
Cordele, GA 31015-3729 - Phone
- (229) 273-8501
- Fax
- (229) 273-2515
- NPI assigned
- Jun 10, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Kevin Holloway, M.D.
- Title
- President
- Phone
- (229) 273-4989
Practitioners 5
-
Kimmie A Carden, PA-C
-
David W Duvall, MD
-
Richard L Stevens, M.D.
-
Melanie Yawn, NP-C
National Provider Directory
Locations
416 E 4th Ave
Ste B
Cordele, GA 31015
Phone (229) 273-8501
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | 060593 | GA | Yes |
Addresses
Primary practice location
416 E 4TH Ave Ste B
Cordele, GA 31015-3729
Mailing address
1801 Quail Run
Cordele, GA 31015-2096
Phone (229) 273-4989
Other providers in Cordele, GA
- Natalie Olivia Ford Cozart
- CRH Vein Center, LLC
- Crisp County Board of Health
- Crisp County Emergency Medical Services
- Crisp County School System
- Crisp Home Care
- Crisp Medical and Kidney Care LLC
- Crisp Medical Equipment LLC
- Crisp Regional Hospital
- Crisp Regional Hospital
All providers in Cordele, GA · Medical Specialty Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2008. 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.