Jose Medina Md Pc

LBN: Jose Medina Md Pc
Jose Medina Md Pc is an health care organization with primary practice located at 3334 Greystone Way , Valdosta GA 31605-1096. The organization recently has only one registered license in Ambulatory Health Care Facilities / Multi-Specialty, which is considered as the primary health care specialty. Jose Medina Md Pc can be contacted via phone (229) 247-1667, or through Medina, Jose via phone (229) 247-1667.

Contact Information

Primary practice address
3334 Greystone Way Valdosta GA 31605-1096
Phone: (229) 247-1667
Fax: (229) 247-3456
Website:
Map and Directions
Authorized official contact:
Name: Medina, Jose Doctor of Medicine (MD)
Phone: (229) 247-1667

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X 041166 Georgia

Profile Details

NPI number 1407047269
LBN Legal business name Jose Medina Md Pc
DBA Doing business as
Authorized official Medina, Jose Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 7th, 2007
Last updated Jun 15th, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407047269 NPPES
Georgia MEDICAID 00686507C

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