Diabetes Center of Jesup LLC
Organization Active NPI Clinic/Center · Jesup, GA
NPI 1780445643 · NPPES record last updated Jan 22, 2024
Key facts
- NPI
- 1780445643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- DIABETES CENTER OF JESUP LLC
- Practice address
- 124 Memorial Dr
Jesup, GA 31545-0101 - Phone
- (912) 750-0011
- Fax
- (833) 740-4346
- NPI assigned
- Jan 18, 2024
- Organization subpart
- No
Authorized official
- Name
- Randall Crawford, FNP
- Title
- Owner
- Phone
- (912) 339-2342
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
124 Memorial Dr
Jesup, GA 31545-0101
Mailing address
24 Glendale Ave Ste E
Baxley, GA 31513-0245
Phone (123) 102-3839
Other providers in Jesup, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2024. 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.