Southern Family Healthcare of Eastman Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

038495 Issued in GA

Legal business name

SOUTHERN FAMILY HEALTHCARE OF EASTMAN INC

Practice address

1112 Plaza Ave
Suite C
Eastman, GA 31023-9009

Phone

(478) 374-1308

Fax

(478) 374-0302

NPI assigned

Jun 6, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John A Glenn Jr., MDNPI 1194765420

Title

Owner

Phone

(478) 374-1308

Specialties & licenses 1

Addresses

Practitioners 2

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

• John A Glenn Jr., MD

  • Family Medicine Physician
  • Eastman, GA
  • NPI 1194765420
  NPD (past) Authorized official
• Habigaile Cribe, MD

  • Internal Medicine Physician
  • Eastman, GA
  • NPI 1275592255
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1902009194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 PLAZA AVE STE C",
            "address_2": "PO BOX 789",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310239012",
            "telephone_number": "478-374-1308",
            "fax_number": "478-374-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 PLAZA AVE",
            "address_2": "SUITE C",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310239009",
            "telephone_number": "478-374-1308",
            "fax_number": "478-374-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN FAMILY HEALTHCARE OF EASTMAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-374-1308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "038495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Smith, NP
• Southeast Georgia Treatment Center
• Southeastern Hospitalist Physicians, LLP
• Brandi Southerland, RD, LD
• Southern Emergency Physicians, LLP
• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.
• Southland Dodge Emergency Medical Services, LLC

• Family Medicine Physician in Eastman, GA
• Providers in Eastman, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.